Provider First Line Business Practice Location Address:
3835 WALLINGFORD 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:
98103-8245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-719-7060
Provider Business Practice Location Address Fax Number:
206-632-6632
Provider Enumeration Date:
05/08/2008