Provider First Line Business Practice Location Address:
5200 S DAWSON 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:
98118-2124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-890-3363
Provider Business Practice Location Address Fax Number:
206-466-2327
Provider Enumeration Date:
12/03/2013