Individual
NICOLE M FETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3303 SW BOND AVE, OHSU DEPARTMENT OF DERMATOLOGY, PORTLAND, OR 97239-4501
(503) 418-3376
Mailing address
3303 SW BOND AVE, OHSU DEPARTMENT OF DERMATOLOGY, PORTLAND, OR 97239-4501
(503) 418-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD162733
OR
207R00000X
Internal Medicine Physician
48458
WI
207R00000X
Internal Medicine Physician
MD436980
PA
Other
Enumeration date
05/03/2006
Last updated
04/23/2013
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