Provider First Line Business Practice Location Address:
1448 NW MARKET STREET
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-427-6325
Provider Business Practice Location Address Fax Number:
206-784-4812
Provider Enumeration Date:
08/31/2006