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Elisha M Fog
Student in an Organized Health Care Education/Training Program in Forest Grove, Oregon
NPI 1487331351

Elisha M Fog is a Student in an Organized Health Care Education/Training Program based in Everett, OR. Elisha M Fog practices in Forest Grove, OR. The NPI Number for Elisha M Fog is 1487331351 and holds a License No. (Oregon).

The current practice location address for Elisha M Fog is 2043 College Way, Forest Grove, OR and can be reached out via phone at 503-352-2020.

Location: 2043 College Way, Forest Grove, OR, 98201-2237
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487331351
Provider Name
Elisha M Fog
Credential
Provider Entity Type
Individual
Gender
Female
Address
2043 College Way, Forest Grove, OR, 98201-2237
Phone Number
503-352-2020
Fax Number
Provider Enumeration Date
06/30/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2043 College Way
City
Forest Grove
State
Oregon
Zip
97116-1756
Phone Number
503-352-2020
Fax Number
person
Provider Business Mailing Address Details
Address
2043 College Way
City
Forest Grove
State
Oregon
Zip
97116-1756
Phone Number
503-352-2020
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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