Individual
ERICA M FABIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2265 EXCHANGE ST, ASTORIA, OR 97103-3331
(503) 338-4075
(503) 338-4076
Mailing address
2111 EXCHANGE ST, ASTORIA, OR 97103-3329
(503) 325-4321
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10010964
OR
363L00000X
Nurse Practitioner
A111917
IA
363LF0000X
Family Nurse Practitioner
A111917
IA
Other
Enumeration date
10/11/2017
Last updated
12/04/2023
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