Provider First Line Business Practice Location Address:
4401 CALIFORNIA AVE SW
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:
98116-4108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-935-5210
Provider Business Practice Location Address Fax Number:
206-932-5958
Provider Enumeration Date:
01/18/2007