Individual
PAVEL FOKSHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 SE 82ND AVE, SUITE 1500, PORTLAND, OR 97266-2924
(503) 772-5333
(503) 772-5366
Mailing address
4000 SE 82ND AVE, SUITE 1500, PORTLAND, OR 97266-2924
(503) 772-5333
(503) 772-5366
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
653593
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274628
—
OR
Enumeration date
02/26/2007
Last updated
12/12/2011
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