Provider First Line Business Practice Location Address:
3225 NE 125TH 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:
98125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-736-5880
Provider Business Practice Location Address Fax Number:
206-838-1503
Provider Enumeration Date:
08/09/2016