Provider First Line Business Practice Location Address:
1560 N 115TH ST STE 101
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:
98133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-668-6806
Provider Business Practice Location Address Fax Number:
206-668-6808
Provider Enumeration Date:
04/05/2013