Provider First Line Business Practice Location Address:
1823 N 85TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-4107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-526-2493
Provider Business Practice Location Address Fax Number:
206-299-9285
Provider Enumeration Date:
12/03/2015