Provider First Line Business Practice Location Address:
6959 CALIFORNIA AVE SW
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:
98136-1953
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-841-2126
Provider Business Practice Location Address Fax Number:
206-932-4856
Provider Enumeration Date:
01/21/2010