Provider First Line Business Practice Location Address:
10100 SE SUNNYSIDE RAOD
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE MT TALBERT MEDICAL OFFICE
Provider Business Practice Location Address City Name:
CLACKAMAS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97015-9764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-571-3733
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2006