Provider First Line Business Practice Location Address:
2400 NE 95TH 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:
98115-2426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-525-5050
Provider Business Practice Location Address Fax Number:
206-525-9795
Provider Enumeration Date:
05/21/2007