Provider First Line Business Practice Location Address:
1519 ALASKAN WAY S
Provider Second Line Business Practice Location Address:
ISC SEATTLE/MEDICAL
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98134-1102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-217-6441
Provider Business Practice Location Address Fax Number:
206-217-6636
Provider Enumeration Date:
10/31/2006