Provider First Line Business Practice Location Address:
4444 WOODLAND PARK AVE N STE 111
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:
98103-7490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-535-9846
Provider Business Practice Location Address Fax Number:
206-374-2779
Provider Enumeration Date:
02/20/2007