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Organization

COLUMBIA SANDS MEDICAL SPECIALITIES, LLC

Active
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Organization

COLUMBIA SANDS MEDICAL SPECIALITIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD W FAWCETT MD (OWNER)
(541) 408-0436
Entity
Organization

Contact information

Practice address
1245 NW 4TH ST STE 201, REDMOND, OR 97756-1680
(541) 526-6626
Mailing address
1245 NW 4TH ST STE 201, REDMOND, OR 97756-1680
(541) 526-6626

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Enumeration date
08/14/2009
Last updated
10/01/2009
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