Provider First Line Business Practice Location Address:
8536 S 117TH PL
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:
98178-4010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-432-9677
Provider Business Practice Location Address Fax Number:
206-432-9677
Provider Enumeration Date:
03/17/2014