Individual
NANCY FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-7112
Mailing address
16221 SE VAN ZYL DR, DAMASCUS, OR 97089-8814
(503) 252-6788
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
011761
OR
Other
Enumeration date
07/07/2015
Last updated
12/30/2021
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