Provider First Line Business Practice Location Address:
1002 E SENECA 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:
98122-4214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-957-1666
Provider Business Practice Location Address Fax Number:
206-325-2689
Provider Enumeration Date:
08/29/2006