Provider First Line Business Practice Location Address:
OHSU DOERNBECHER
Provider Second Line Business Practice Location Address:
3181 SW SAM JACKSON PARK ROAD
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97239-1002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-494-7500
Provider Business Practice Location Address Fax Number:
503-494-4997
Provider Enumeration Date:
06/29/2013