Individual
NICOLE MARIE FASSIOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 SW CAMPUS DR, PORTLAND, OR 97239-3107
(503) 494-3151
Mailing address
4521 SE ARDEN ST, MILWAUKIE, OR 97222-5003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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