Provider First Line Business Practice Location Address:
753 N 35TH STREET, SUITE 310
Provider Second Line Business Practice Location Address:
FREMONT PROFESSIONAL CENTER
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-8873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-539-0525
Provider Business Practice Location Address Fax Number:
425-553-3988
Provider Enumeration Date:
02/28/2020