Provider First Line Business Practice Location Address:
1419 3RD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101-2105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-838-8480
Provider Business Practice Location Address Fax Number:
206-838-8481
Provider Enumeration Date:
11/07/2008