Provider First Line Business Practice Location Address:
60 S SPOKANE 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:
98134-2245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-535-2445
Provider Business Practice Location Address Fax Number:
206-535-2445
Provider Enumeration Date:
01/21/2015