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Individual

MR. WILLIEFRED M FORTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5050 NE HOYT, #414, PORTLAND, OR 97213
(503) 235-5724
(503) 254-7892
Mailing address
5050 NE HOYT, #414, PORTLAND, OR 97213
(503) 235-5724
(503) 254-7892

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD19912
OR

Other

Enumeration date
11/22/2006
Last updated
07/08/2007
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