Provider First Line Business Practice Location Address:
1601 N 52ND 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:
98103-6109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-915-9533
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2015