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Individual

BRENDA M FALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA/RA, RT(R)

Contact information

Practice address
545 NE 47TH AVE, SUITE 215, PORTLAND, OR 97213-2238
(971) 344-0499
Mailing address
545 NE 47TH AVE, SUITE 215, PORTLAND, OR 97213-2238
(971) 344-0499

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
06 WA 1235
247100000X
Radiologic Technologist
106318
OR

Other

Enumeration date
05/14/2008
Last updated
10/13/2008
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