Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | DO180852 | OR |
NPI | 1033484506 |
---|---|
Provider Name | Margaret Sara Fairhurst |
First Address | Portland, OR 97208-3158 |
Second Address | Medford, OR 97504-5590 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2012 |
Last Update Date | 02/10/2020 |