Individual
CHARLOTTE KATHLEEN FARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3810 SE BELMONT ST, PORTLAND, OR 97214-4330
(971) 226-1577
Mailing address
3810 SE BELMONT ST, PORTLAND, OR 97214-4330
(971) 226-1577
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19581
OR
Other
Enumeration date
05/16/2013
Last updated
02/08/2016
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