Provider First Line Business Practice Location Address:
121N BROADWAY ST
Provider Second Line Business Practice Location Address:
NW CENTER FOR NATURAL MEDICINE
Provider Business Practice Location Address City Name:
ESTACADA
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-630-6288
Provider Business Practice Location Address Fax Number:
503-630-2245
Provider Enumeration Date:
10/14/2008