Individual
MARTHA L FIALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
403 SW DENNIS AVE, HILLSBORO, OR 97123-3928
(503) 640-3803
Mailing address
12525 SW TOOZE RD, SHERWOOD, OR 97140-8442
(503) 319-8848
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0280
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015128
—
OR
01
—
838351001
BLUE CROSS BLUE SHEILD
OR
Enumeration date
12/15/2005
Last updated
09/25/2015
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