Provider First Line Business Practice Location Address:
UWMC-ROOSEVELT
Provider Second Line Business Practice Location Address:
4245 ROOSEVELT WAY NE
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98105-6920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-598-8750
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2006