Provider First Line Business Practice Location Address:
1600 E OLIVE ST
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:
98122-2735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-302-2220
Provider Business Practice Location Address Fax Number:
206-302-2210
Provider Enumeration Date:
12/31/2015