Provider First Line Business Practice Location Address:
2401 N 45TH 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:
98103-6968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-632-1214
Provider Business Practice Location Address Fax Number:
206-634-1229
Provider Enumeration Date:
11/02/2006