Provider First Line Business Practice Location Address:
7272 W MARGINAL WAY S
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:
98108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-285-9140
Provider Business Practice Location Address Fax Number:
206-764-8273
Provider Enumeration Date:
02/22/2007