Individual
TRISTAN NADIENE FUJITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC-R, OTC
Contact information
Practice address
831 NW COUNCIL DR STE 130, GRESHAM, OR 97030-3722
(503) 489-1122
Mailing address
16790 SE DAVIDOFF WAY, DAMASCUS, OR 97089-5807
(360) 204-1035
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT-AT-10139459
OR
246ZS0410X
Surgical Technologist
Primary
—
OR
Other
Enumeration date
05/04/2011
Last updated
03/04/2014
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