Provider First Line Business Practice Location Address:
8311 BEACON AVE S
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:
98118-4323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-252-7500
Provider Business Practice Location Address Fax Number:
206-743-3180
Provider Enumeration Date:
12/21/2012