Individual
JANE A FORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 SIXTH ST, LEWISTON, ID 83501
(208) 750-7445
Mailing address
1119 HIGHLAND AVE, SUITE 7, CLARKSTON, WA 99403-2836
(509) 758-1119
(509) 758-1140
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-4493
ID
207R00000X
Internal Medicine Physician
MD00036657
WA
Other
Enumeration date
07/09/2006
Last updated
11/10/2019
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