Provider First Line Business Practice Location Address:
1320 UNIVERSITY ST STE 2
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:
98101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-466-2351
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2014