Provider First Line Business Practice Location Address:
314 W GALER STREET
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-486-2742
Provider Business Practice Location Address Fax Number:
425-364-4076
Provider Enumeration Date:
02/17/2026