Provider First Line Business Practice Location Address:
6522 FREMONT AVE N
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:
98103-5358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-376-4700
Provider Business Practice Location Address Fax Number:
206-299-4449
Provider Enumeration Date:
09/08/2010