Provider First Line Business Practice Location Address:
GRADUATE MEDICAL EDUCATION LEGACY GOOD SAMARITAN MEDICA
Provider Second Line Business Practice Location Address:
1015 NW 22ND AVENUE
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-413-7036
Provider Business Practice Location Address Fax Number:
503-413-7361
Provider Enumeration Date:
04/05/2022