Provider First Line Business Practice Location Address:
1959 NE PACIFIC ST
Provider Second Line Business Practice Location Address:
UNIVERSITY OF WASHINGTON MEDICAL CENTER
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-6159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-598-1917
Provider Business Practice Location Address Fax Number:
206-598-2359
Provider Enumeration Date:
09/22/2011