Provider First Line Business Practice Location Address:
7220 5TH AVE NW
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:
98117-4917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-433-8697
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2026