Provider First Line Business Practice Location Address:
3412 W MCGRAW ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98199-3244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-284-5660
Provider Business Practice Location Address Fax Number:
206-284-6908
Provider Enumeration Date:
12/04/2006