Provider First Line Business Practice Location Address:
2501 S PLUM 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:
98144-4711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-436-2228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2011