Provider First Line Business Practice Location Address:
1325 6TH AVE
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:
98101-2304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-839-4780
Provider Business Practice Location Address Fax Number:
206-839-4786
Provider Enumeration Date:
02/28/2007