Provider First Line Business Practice Location Address:
7711 43RD AVE NE
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:
98115-5109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-252-5307
Provider Business Practice Location Address Fax Number:
206-743-3178
Provider Enumeration Date:
11/20/2012