Organization
FITZGERALD FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERIN SANFORD FITZGERALD FNP-BC (NURSE PRACTITIONER)
(971) 612-1588
Entity
Organization
Contact information
Practice address
289 E ELLENDALE AVE STE 602, DALLAS, OR 97338-1570
(971) 612-1588
(503) 831-3215
Mailing address
170 W ELLENDALE AVE STE 103, DALLAS, OR 97338-1456
(971) 612-1588
(503) 831-3215
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
2015011081
OR
Other
Enumeration date
05/06/2018
Last updated
05/06/2018
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