Dale Fossati

NPI 1023121118 - Physician Assistant - 363AM0700X

NPI Details
NPI 1023121118
Gender Male
Enumeration Date 08/16/2006
Last Updated 07/14/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
9900 SE SUNNYSIDE RD
CLACKAMAS OR, 97015-9777, US
Phone (503) 571-8240
Fax
Business Location
9900 SE SUNNYSIDE RD
CLACKAMAS OR, 97015-9777, US
Phone
Fax
Toxanomy
Taxonomy Code 363AM0700X
License State Oregon
License Number OR PA00125
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According to our database, Dale Fossati NPI is 1023121118, taxonomy code is 363AM0700X and license number is OR PA00125, license state is located at Oregon. Dale Fossati physically located at 9900 Se Sunnyside Rd, Clackamas OR, 97015-9777. NPI Number Dale Fossati has the Individual type.

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1023121118 NPI number is provided on an as is basis without warranty of any kind. 1023121118 is maintained by the National Plan & Provider Enumeration System. The contents of Dale Fossati are for informational purposes only.