Individual
FALLON N POLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 ALLISON ST, ASHLAND, OR 97520-2910
(406) 868-6458
Mailing address
590 ALLISON ST, ASHLAND, OR 97520-2910
(406) 868-6458
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201909188RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202110122NP-PP
OR
Other
Enumeration date
08/27/2021
Last updated
11/05/2021
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