Provider First Line Business Practice Location Address:
5950 6TH AVE S
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98108-3317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-805-1930
Provider Business Practice Location Address Fax Number:
206-805-1931
Provider Enumeration Date:
10/18/2012