Provider First Line Business Practice Location Address:
3920 15TH AVE NE
Provider Second Line Business Practice Location Address:
UW MAILSTOP 351635
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-1635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-543-6511
Provider Business Practice Location Address Fax Number:
206-616-8367
Provider Enumeration Date:
08/07/2013