Provider First Line Business Practice Location Address:
4245 ROOSEVELT WAY NE BOX 354755
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:
98105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-598-6868
Provider Business Practice Location Address Fax Number:
206-598-2847
Provider Enumeration Date:
05/12/2015