Provider First Line Business Practice Location Address:
2351 10TH AVE E STE A
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:
98102-4009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-487-4884
Provider Business Practice Location Address Fax Number:
206-492-2023
Provider Enumeration Date:
05/02/2019