Provider First Line Business Practice Location Address:
5701 3RD AVE S STE B
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:
98108-2437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-347-3030
Provider Business Practice Location Address Fax Number:
206-347-3031
Provider Enumeration Date:
04/25/2019