Individual
MISS ELIZABETH ELLEN FUEGY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
20 SW CUSTER STREET, PORTLAND, OR 97219-2900
(503) 351-2973
Mailing address
20 SW CUSTER ST, PORTLAND, OR 97219-2900
(503) 351-2973
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
9828672
OR
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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