Provider First Line Business Practice Location Address:
9730 3RD AVE NE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-526-9999
Provider Business Practice Location Address Fax Number:
206-526-9995
Provider Enumeration Date:
04/23/2008