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Organization

FIBROMYALGIA FOCUS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHERYL ANN HRYCIW MS, FNP (NURSE PRACTITIONER)
(971) 344-8600
Entity
Organization

Contact information

Practice address
1675 SW MARLOW AVE, SUITE 210B, PORTLAND, OR 97225-5104
(503) 389-3106
(503) 546-4223
Mailing address
1675 SW MARLOW AVE STE 210B, PORTLAND, OR 97225-5162
(503) 389-3106
(503) 546-4223

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200150080
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R180604
MEDICARE PTAN
OR
Enumeration date
01/30/2016
Last updated
02/13/2017
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