Provider First Line Business Practice Location Address:
7043 26TH AVE NW
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:
98117-5851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-782-7163
Provider Business Practice Location Address Fax Number:
206-782-9109
Provider Enumeration Date:
04/30/2008