Provider First Line Business Practice Location Address:
3323 WETMORE 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:
98144-6931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-354-5384
Provider Business Practice Location Address Fax Number:
206-829-8333
Provider Enumeration Date:
07/13/2011