Provider First Line Business Practice Location Address:
3241 35TH AVE SW
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:
98126-2201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-865-6151
Provider Business Practice Location Address Fax Number:
413-931-2988
Provider Enumeration Date:
01/16/2007