Provider First Line Business Practice Location Address:
7900 E GREEN LAKE DR N
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-4800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-641-7212
Provider Business Practice Location Address Fax Number:
206-734-3211
Provider Enumeration Date:
07/08/2010