Individual
FRANCES BUBALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4535 SW TARLOW CT, PORTLAND, OR 97221-3681
(503) 246-6256
Mailing address
4535 SW TARLOW CT, PORTLAND, OR 97221-3681
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD17803
OR
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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