Provider First Line Business Practice Location Address:
OREGON STATE PENITENTIARY
Provider Second Line Business Practice Location Address:
2605 STATE STREET
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-378-2446
Provider Business Practice Location Address Fax Number:
503-378-3228
Provider Enumeration Date:
05/11/2007