Provider First Line Business Practice Location Address:
8830 ROOSEVELT WAY NE
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:
98115-3042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-729-7514
Provider Business Practice Location Address Fax Number:
206-729-7513
Provider Enumeration Date:
08/10/2006