Provider First Line Business Practice Location Address:
314 W GALER ST
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98119-3393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-686-9441
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2014