Individual
AMANDA FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 382-4321
Mailing address
PO BOX 6096, BEND, OR 97708-6096
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/14/2011
Last updated
04/20/2020
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