Provider First Line Business Practice Location Address:
1800 E SHELBY 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:
98112-2022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-241-5997
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2013