Provider First Line Business Practice Location Address:
1101 MADISON STREET
Provider Second Line Business Practice Location Address:
SUITE 200 SPD PAIN MANAGEMENT
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104-1306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-386-2013
Provider Business Practice Location Address Fax Number:
206-386-2149
Provider Enumeration Date:
08/30/2006