Provider First Line Business Practice Location Address:
1600 E JEFFERSON
Provider Second Line Business Practice Location Address:
SUITE A5
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-320-8085
Provider Business Practice Location Address Fax Number:
206-320-4747
Provider Enumeration Date:
04/09/2007