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Individual

MR. EMERY JAMES FAIRCHILD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
(503) 570-3315
Mailing address
11850 SW ALLEN BLVD, BEAVERTON, OR 97005-4805
(503) 646-7164

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
OR

Other

Enumeration date
06/25/2015
Last updated
06/25/2015
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