Provider First Line Business Practice Location Address:
12001 4TH AVE NW
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:
98177-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-465-6601
Provider Business Practice Location Address Fax Number:
206-306-8946
Provider Enumeration Date:
03/05/2007