Provider First Line Business Practice Location Address:
12736 33RD AVE NE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98125-4504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-367-0135
Provider Business Practice Location Address Fax Number:
206-367-0150
Provider Enumeration Date:
05/04/2010