Individual
WERAKA FOGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18318 NE FLANDERS ST, PORTLAND, OR 97230-7246
(510) 229-8243
(503) 512-7106
Mailing address
18318 NE FLANDERS ST, PORTLAND, OR 97230-7246
(510) 229-8243
(503) 512-7106
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
283198
OR
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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