Provider First Line Business Practice Location Address:
4400 INTERLAKE 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:
98103-7519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-548-5760
Provider Business Practice Location Address Fax Number:
206-632-0132
Provider Enumeration Date:
11/11/2015