Provider First Line Business Practice Location Address:
1550 NORTH 115TH STREET
Provider Second Line Business Practice Location Address:
BOX 358828, UW MEDICAL CENTER-NORTHWEST
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-543-3750
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2019