Provider First Line Business Practice Location Address:
1959 NE PACIFIC STR.
Provider Second Line Business Practice Location Address:
UNIVERSITY OF WASHINGTON, DEPARTMENT OF SURGERY
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-6410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-543-3687
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2010