Provider First Line Business Practice Location Address:
6303 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:
98103-5558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-789-4066
Provider Business Practice Location Address Fax Number:
206-789-0258
Provider Enumeration Date:
04/11/2007