Provider First Line Business Practice Location Address:
1959 NE PACIFIC STREET, BOX 357134
Provider Second Line Business Practice Location Address:
HEALTH SCIENCES BUILDING ROOM B-241
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-543-7722
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2024