Provider First Line Business Practice Location Address:
8537 PHINNEY AVE N
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:
98103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-784-9806
Provider Business Practice Location Address Fax Number:
206-789-6312
Provider Enumeration Date:
11/06/2006