| Street | 1175 E 29th Ave | ||
| City/Town | Eugene | ||
| State/Province/Region | Oregon | ||
| Zip/Postal Code | 97403 | ||
| Phone Number | (541) 485-7218 | ||
| Country | United States |
| Full Name | Dr. Morton Welch MD | ||
| Gender | male | ||
| Birthday | 1993-05-20 | ||
| Social Security Number | 518-89-9849 |
| Credit card brand | Discover | ||
| Credit card number | 6011046041726370 | ||
| Expire | 2030/3 | ||
| CVV | 315 |