Provider First Line Business Practice Location Address:
19260 SW 65TH AVE THE CHILDREN' S CLINIC
Provider Second Line Business Practice Location Address:
SUITE 340
Provider Business Practice Location Address City Name:
TUALATIN
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-691-9777
Provider Business Practice Location Address Fax Number:
503-692-6736
Provider Enumeration Date:
10/01/2018