COFFEE CREEK CORRECTION FACILITY

PORTLAND, OR
NPI1619397767
Entity TypeOrganization
Authorized ContactDERALD WALKER
President / CEO
503-238-0769
Organization Subpart ?Yes
Primary Taxonomy261QM1300X Clinic/Center Multi-Specialty
Enumeration Date2014-04-16
Last Update Date2014-04-16
Business Address
COFFEE CREEK CORRECTION FACILITY
847 NE 19TH AVE SUITE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
Mailing Address
COFFEE CREEK CORRECTION FACILITY
847 NE 19TH AVE SUITE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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