Provider First Line Business Practice Location Address:
1660 SOUTH COLUMBIAN WAY (116-MHC)
Provider Second Line Business Practice Location Address:
VA PUGET SOUND HEALTH CARE SYSTEM
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-277-4386
Provider Business Practice Location Address Fax Number:
206-764-2572
Provider Enumeration Date:
09/05/2006