Provider First Line Business Practice Location Address:
3208 NW 60TH
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:
98107-2609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-784-7938
Provider Business Practice Location Address Fax Number:
206-782-0485
Provider Enumeration Date:
12/12/2006