Jeffrey D Fullman, MD
Internal Medicine in Tualatin, OR. Individual provider (NPI-1).
NPI number1932178951
StatusActive
Last updated in NPPESJul 19, 2010
Details
- NPI
- 1932178951
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey D Fullman
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2006
- Last updated
- Jul 19, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | MD13393 | OR | Yes |
Practice location
19250 Sw 65th AveSte 110
Tualatin, OR 97062-7452
Phone 503-692-1205 · Fax 503-692-1207
Mailing address
1411 Sw Morrison StSte 200
Portland, OR 97205-1945
Phone 503-242-9850 · Fax 503-279-8157
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