Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | MD177473 | OR |
NPI | 1013203348 |
---|---|
Provider Name | Dr. Jaime Erin Fair |
First Address | Portland, OR 97239-3011 |
Second Address | Springfield, OR 97477-8800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500683461 | (05) | OR |