Provider First Line Business Practice Location Address:
LEGACY GOOD SAMARITAN MEDICAL CENTER- GME
Provider Second Line Business Practice Location Address:
1015 NW 22ND AVE
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-413-8401
Provider Business Practice Location Address Fax Number:
503-413-7361
Provider Enumeration Date:
04/29/2022