Individual
BRUCE L. FAIRMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. L.P.C.
Contact information
Practice address
1686 N COAST HWY, NEWPORT, OR 97365-2357
(541) 265-6148
Mailing address
PO BOX 1206, NEWPORT, OR 97365
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
CO #333
OR
Other
Enumeration date
10/05/2006
Last updated
04/09/2015
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