Individual
PELELINI FATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3231 SE 50TH AVE, PORTLAND, OR 97206-2248
(503) 984-3494
Mailing address
13030 SE DIVISION ST, PORTLAND, OR 97236-3039
(971) 351-9236
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
25-CRM-4088
OR
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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