Provider First Line Business Practice Location Address:
2101 N 34TH ST STE 170
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:
98103-9177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-547-4131
Provider Business Practice Location Address Fax Number:
206-547-8157
Provider Enumeration Date:
03/29/2007