Provider First Line Business Practice Location Address:
3245 FAIRVIEW AVENUE EAST
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-781-5611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/27/2006