Provider First Line Business Practice Location Address:
4400 37TH AVE S
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:
98118-1609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-461-6957
Provider Business Practice Location Address Fax Number:
206-461-7810
Provider Enumeration Date:
12/13/2005