Individual
PATRICIA FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6350 NE HALSEY ST, PORTLAND, OR 97213-4720
(503) 215-2669
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD166103
OR
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MD166103
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500667940
—
OR
Enumeration date
06/02/2011
Last updated
02/12/2021
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