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1245624980
JARED MICHAEL FAIRCHILD
PORTLAND, OR
NPI
1245624980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: OR 201605090CRNA-PP)
Enumeration Date
2015-03-19
Last Update Date
2019-05-28
Business Address
JARED MICHAEL FAIRCHILD CRNA
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-4910
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Mailing Address
JARED MICHAEL FAIRCHILD CRNA
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 773-405-3545
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