Organization
FETTLE BOTANIC SUPPLY & COUNSEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JJ PURSELL (PRESIDENT)
(503) 234-7801
Entity
Organization
Contact information
Practice address
3327 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5046
(503) 234-7801
Mailing address
3327 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5046
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1607
OR
Other
Enumeration date
05/20/2012
Last updated
01/25/2017
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