Provider First Line Business Practice Location Address:
13720 CLACKAMAS RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OREGON CITY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97045-9484
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-656-1956
Provider Business Practice Location Address Fax Number:
503-723-0840
Provider Enumeration Date:
04/16/2007