Individual
MEGAN FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 SW OAK ST, PORTLAND, OR 97204-1817
(503) 867-6722
Mailing address
12621 SE BUSH ST, PORTLAND, OR 97236-3422
(503) 880-8815
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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