Provider First Line Business Practice Location Address:
6400 28TH AVE NW
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:
98107-2449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-354-7242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2025