Provider First Line Business Practice Location Address:
2801 N GANTENBIEN
Provider Second Line Business Practice Location Address:
LEGACY EMANUEL HOSPITAL AND MEDICAL CENTER
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-413-4278
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/17/2006