Provider First Line Business Practice Location Address:
2350 NE 95TH 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:
98115-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-788-4140
Provider Business Practice Location Address Fax Number:
206-788-4159
Provider Enumeration Date:
04/09/2007