Provider First Line Business Practice Location Address:
2150 NORTH 107TH
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-629-2186
Provider Business Practice Location Address Fax Number:
888-316-3489
Provider Enumeration Date:
10/12/2011