Provider First Line Business Practice Location Address:
1205 N 145TH 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:
98133-6202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-363-9223
Provider Business Practice Location Address Fax Number:
206-363-6550
Provider Enumeration Date:
01/23/2007