Provider First Line Business Practice Location Address:
2625 S MORGAN 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:
98108-3704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-246-6898
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2016