Provider First Line Business Practice Location Address:
7101 ML KING JR. WAY SOUTH
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-722-8858
Provider Business Practice Location Address Fax Number:
206-722-0992
Provider Enumeration Date:
07/10/2010