Provider First Line Business Practice Location Address:
3324 RAINIER AVE S
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:
98144-6034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-322-6915
Provider Business Practice Location Address Fax Number:
206-395-2315
Provider Enumeration Date:
04/12/2007