Provider First Line Business Practice Location Address:
7148 MARTIN LUTHER KING JR WAY S
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:
98118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-725-7176
Provider Business Practice Location Address Fax Number:
206-723-1656
Provider Enumeration Date:
12/05/2006