Provider First Line Business Practice Location Address:
1959 NORTHEAST PACIFIC STREET,
Provider Second Line Business Practice Location Address:
BOX 357115 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:
98115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-598-5130
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2017