Registry details
Type
Individual
Primary specialty
Radiology, Pediatric Radiology
Enumerated
May 13, 2014
License(s)
4301503485 (MI), MD61039865 (WA), MD61039865 (WA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 19020 33RD AVE W STE 210 | Lynnwood, WA 98036-4748 | 425-563-1500 |
| MAILING | 19020 33RD AVE W STE 210 | Lynnwood, WA 98036-4748 | 425-563-1500 |
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