Provider First Line Business Practice Location Address:
747 BROADWAY, SUITE 739 WEST
Provider Second Line Business Practice Location Address:
SWEDISH MEDICAL CENTER, GENERAL SURGERY PROGRAM
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
98101-4307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-386-2123
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2012