Provider First Line Business Practice Location Address:
2101 E YESLER WAY
Provider Second Line Business Practice Location Address:
STE. 210
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122-5959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-299-1937
Provider Business Practice Location Address Fax Number:
206-299-1920
Provider Enumeration Date:
01/30/2008