Provider First Line Business Practice Location Address:
SKYLINE MEDICAL OFFICE, 5125 SKYLINE RD, S
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97306-9427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-588-5985
Provider Business Practice Location Address Fax Number:
503-588-5957
Provider Enumeration Date:
08/14/2006