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1013758911
KATHERINE KELLY FOSSETTA
PORTLAND, OR
NPI
1013758911
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-06-04
Last Update Date
2024-06-04
Business Address
KATHERINE KELLY FOSSETTA Physician Assistant
2730 S MOODY AVE
PORTLAND, OR 97201-5042
Phone number: 503-494-9645
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Mailing Address
KATHERINE KELLY FOSSETTA Physician Assistant
2730 S MOODY AVE
PORTLAND, OR 97201-5042
Phone number:
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