Provider First Line Business Practice Location Address:
8266 LAKE CITY WAY NE, STE 3C
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-205-9236
Provider Business Practice Location Address Fax Number:
866-313-2486
Provider Enumeration Date:
04/17/2007