LYLE JAMES FAGNAN

PORTLAND, OR
NPI1669487161
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: OR  MD10673)
Enumeration Date2006-07-31
Last Update Date2007-07-13
Business Address
LYLE JAMES FAGNAN MD
4411 SW VERMONT ST
PORTLAND, OR 97219-1020
Phone number: 503-494-9992
Mailing Address
LYLE JAMES FAGNAN MD
3181 SW SAM JACKSON PARK RD L222
PORTLAND, OR 97239-3011
Phone number: 503-494-1582