Provider First Line Business Practice Location Address:
200 LAKE WASHINGTON BLVD
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:
98122-6591
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-322-8862
Provider Business Practice Location Address Fax Number:
206-267-0866
Provider Enumeration Date:
09/16/2009