Individual
DOLORES L FOGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1321 NE 99TH AVE, SUITE 100, PORTLAND, OR 97220-9436
(503) 215-9900
(503) 215-4055
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
078041103N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500028673
RR MEDICARE
OR
Enumeration date
10/04/2006
Last updated
04/13/2012
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