Provider First Line Business Practice Location Address:
901 12TH AVE
Provider Second Line Business Practice Location Address:
GARRAND HALL 200C
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122-4411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-296-5678
Provider Business Practice Location Address Fax Number:
206-296-5544
Provider Enumeration Date:
09/04/2006