ALISE FAIRCLOTH

Contractor

Active Individual
NPI: 1801262589

Practice Address

1921 SW 144TH AVE
Beaverton, OR 97005

Phone: (503) 704-6982

Specialties

Specialty Code Primary License
Contractor 171W00000X Yes 21439 (OR)

Frequently Asked Questions

NPI 1801262589 is the National Provider Identifier for ALISE FAIRCLOTH, a Contractor provider located in Beaverton, OR. This NPI was enumerated on August 17, 2015.
ALISE FAIRCLOTH practices at 1921 SW 144TH AVE, Beaverton, OR 97005.

Quick Facts

NPI
1801262589
Type
Individual
Enumerated
Aug 17, 2015
Last Updated
Aug 17, 2015

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