JENNIFER MARY FASULO

PORTLAND, OR
NPI1730480831
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: OR  201243142RN)
Enumeration Date2010-11-05
Last Update Date2012-11-02
Business Address
-- JENNIFER MARY FASULO RN
3734 SE 15TH AVE APT 1
PORTLAND, OR 97202-3857
Phone number: 203-228-0805
Mailing Address
-- JENNIFER MARY FASULO RN
510 E 15TH ALY APT 3
EUGENE, OR 97401-4580
Phone number: 203-228-0805