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Individual

JARED MICHAEL FAIRCHILD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-4910
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(773) 405-3545

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201605090CRNA-PP
OR

Other

Enumeration date
03/19/2015
Last updated
05/28/2019
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