Provider First Line Business Practice Location Address:
3308 E SPRING ST
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:
98122-5127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-825-0251
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2024