Provider First Line Business Practice Location Address:
3216 NE 45 PL
Provider Second Line Business Practice Location Address:
STE 303W
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-903-9434
Provider Business Practice Location Address Fax Number:
206-529-0129
Provider Enumeration Date:
02/11/2008