Provider First Line Business Practice Location Address:
3429 45TH AVE SW
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:
98116-3330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-933-7842
Provider Business Practice Location Address Fax Number:
206-933-7913
Provider Enumeration Date:
10/10/2014