Provider First Line Business Practice Location Address:
1414 E YESLER WAY
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:
98122-5508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-324-2232
Provider Business Practice Location Address Fax Number:
206-324-6006
Provider Enumeration Date:
05/25/2006