Provider First Line Business Practice Location Address:
5024 SW DAWSON 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:
98136-1033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-356-9573
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2007