Individual
MR. SEAN FAIRBAIRN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN RN CNOR RNFA
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 301-6325
Mailing address
2986 SECKEL ST, MEDFORD, OR 97504-8168
(541) 301-6325
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
201706664RN
OR
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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