Provider First Line Business Practice Location Address:
4560 SE INTERNATIONAL WAY
Provider Second Line Business Practice Location Address:
CONSONUS HEALTHCARE SERVICES SUITE 100
Provider Business Practice Location Address City Name:
MILWAUKIE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-891-7575
Provider Business Practice Location Address Fax Number:
971-206-5203
Provider Enumeration Date:
05/30/2007