Provider First Line Business Practice Location Address:
3600 NORTH INTERSTATE PORTLAND
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE CENTRAL INTERSTATE
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97227-1106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-944-2713
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2011