Provider First Line Business Practice Location Address:
1901 SW GENESEE ST
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:
98106-1280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-766-1653
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2024