Provider First Line Business Practice Location Address:
909 UNIVERSITY ST
Provider Second Line Business Practice Location Address:
HEALTH RESOURCES BLDG, MAILSTOP: G2-EH
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101-2772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-341-0575
Provider Business Practice Location Address Fax Number:
206-223-6856
Provider Enumeration Date:
06/11/2008