Provider First Line Business Practice Location Address:
1417 NE 42ND ST
Provider Second Line Business Practice Location Address:
DEPT OF SPHSC, UNIVERSITY OF WASHINGTON
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98105-6247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-616-2753
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2010