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1730480831
JENNIFER MARY FASULO
PORTLAND, OR
NPI
1730480831
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: OR 201243142RN)
Enumeration Date
2010-11-05
Last Update Date
2012-11-02
Business Address
-- JENNIFER MARY FASULO RN
3734 SE 15TH AVE APT 1
PORTLAND, OR 97202-3857
Phone number: 203-228-0805
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Mailing Address
-- JENNIFER MARY FASULO RN
510 E 15TH ALY APT 3
EUGENE, OR 97401-4580
Phone number: 203-228-0805
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