Provider First Line Business Practice Location Address:
341 NE 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERMISTON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97838-1807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-667-6000
Provider Business Practice Location Address Fax Number:
541-667-6052
Provider Enumeration Date:
10/09/2006