Individual
DEBORAH FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
700 SW CAMPUS DR, PORTLAND, OR 97239-3107
(503) 346-0640
Mailing address
700 SW CAMPUS DR, PORTLAND, OR 97239-3107
(503) 346-0640
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201150048NP
OR
Other
Enumeration date
06/01/2011
Last updated
01/24/2017
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