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1518648351
ANGELA NICOLE FAIRLESS
ASTORIA, OR
NPI
1518648351
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-07-25
Last Update Date
2023-07-25
Business Address
ANGELA NICOLE FAIRLESS
115 W BOND ST
ASTORIA, OR 97103-6009
Phone number: 503-325-5722
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Mailing Address
ANGELA NICOLE FAIRLESS
65 N HIGHWAY 101 STE 204
WARRENTON, OR 97146-9371
Phone number: 503-325-5722
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