Provider First Line Business Practice Location Address:
5437 CALIFORNIA AVE SW
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:
98136-1583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-778-2020
Provider Business Practice Location Address Fax Number:
206-937-2942
Provider Enumeration Date:
05/23/2007