Individual
MR. PHILIP A FLEURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
4610 SE BELMONT, SUITE 60, PORTLAND, OR 97215
(503) 988-5303
(503) 988-5112
Mailing address
2623 NE 24TH AVE, PORTLAND, OR 97212-4833
(503) 287-7472
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
081001212N3
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067959
—
OR
Enumeration date
08/09/2006
Last updated
07/08/2007
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