Individual
MS. FANNY MARICELA ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
THW, BA
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-9203
(503) 988-3606
Mailing address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-9203
(503) 988-3606
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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