Provider First Line Business Practice Location Address:
11300 SE 23RD AVENUE
Provider Second Line Business Practice Location Address:
MILWAUKIE HIGH SCHOOL HEALTH & WELLNESS CENTER
Provider Business Practice Location Address City Name:
MILWAUKIE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97222-7753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-535-3861
Provider Business Practice Location Address Fax Number:
503-223-6837
Provider Enumeration Date:
11/17/2011