| Street | 9943 E Burnside St |
| City/Town | Portland |
| State/Province/Region | Oregon |
| Zip/Postal Code | 97216 |
| Phone Number | (503) 641-0200 |
| Country | United States |
| Latitude | 45.52336 |
| Longitude | -122.561365 |
| Full Name | Mrs. Ericka Crooks II |
| Gender | female |
| Birthday | 1976-06-28 |
| Social Security Number | 541-83-4254 |
| Credit card brand | JCB |
| Credit card number | 3533030268882278 |
| Expire | 2023/1 |
| CVV | 832 |