Provider First Line Business Practice Location Address:
OREGON STATE HOSPITAL
Provider Second Line Business Practice Location Address:
2600 CENTER STREET NE
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-945-0963
Provider Business Practice Location Address Fax Number:
503-373-1681
Provider Enumeration Date:
02/21/2020