Individual
MILLIE BARBARA FABER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
5300 SW 180TH AVE APT 12, BEAVERTON, OR 97078-3235
(714) 815-7066
Mailing address
5300 SW 180TH AVE APT 12, BEAVERTON, OR 97078-3235
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160972830
WA
Other
Enumeration date
02/19/2018
Last updated
03/18/2020
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