Provider First Line Business Practice Location Address:
1015 8TH AVE N
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:
98109-3504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-242-9081
Provider Business Practice Location Address Fax Number:
866-433-3965
Provider Enumeration Date:
02/01/2010