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1023121118
DALE FOSSATI
CLACKAMAS, OR
NPI
1023121118
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: OR OR PA00125)
Enumeration Date
2006-08-16
Last Update Date
2007-07-14
Business Address
-- DALE FOSSATI
9900 SE SUNNYSIDE RD
CLACKAMAS, OR 97015-9777
Phone number: 503-571-8240
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Mailing Address
-- DALE FOSSATI
9900 SE SUNNYSIDE RD
CLACKAMAS, OR 97015-9777
Phone number:
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