Provider First Line Business Practice Location Address:
8540 1ST AVE NW
Provider Second Line Business Practice Location Address:
STE 8
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-801-3900
Provider Business Practice Location Address Fax Number:
360-786-1603
Provider Enumeration Date:
07/27/2006