Provider First Line Business Practice Location Address:
2201 NE 65TH ST
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:
98115-7020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-535-7356
Provider Business Practice Location Address Fax Number:
206-466-1527
Provider Enumeration Date:
05/11/2012