Provider First Line Business Practice Location Address:
4000 NE 41ST STREET
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:
98105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-729-2598
Provider Business Practice Location Address Fax Number:
206-324-3825
Provider Enumeration Date:
07/22/2009