Provider First Line Business Practice Location Address:
8610 8TH AVE NE
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:
98115-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-985-6646
Provider Business Practice Location Address Fax Number:
206-985-6687
Provider Enumeration Date:
02/28/2007