Provider First Line Business Practice Location Address:
1010 S. 146TH STREET
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:
98168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-439-2666
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/13/2012