Provider First Line Business Practice Location Address:
18550 SW KINNAMAN RD
Provider Second Line Business Practice Location Address:
ALOHA HIGH SCHOOL
Provider Business Practice Location Address City Name:
BEAVERTON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97007-2465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-259-4864
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2006