Provider First Line Business Practice Location Address:
3515 SW ALASKA ST
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:
98126-2730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-979-8787
Provider Business Practice Location Address Fax Number:
206-309-3373
Provider Enumeration Date:
01/11/2013