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1952305385
ELISE JAN FULSANG
PORTLAND, OR
NPI
1952305385
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OR MD23553)
Enumeration Date
2005-06-13
Last Update Date
2011-04-06
Business Address
Dr. ELISE JAN FULSANG MD
300 N GRAHAM ST SUITE 200
PORTLAND, OR 97227-1683
Phone number: 503-413-4134
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Mailing Address
Dr. ELISE JAN FULSANG MD
24800 SE STARK ST. SUITE 200
GRESHAM, OR 97030
Phone number: 503-674-1391
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