Fulsang, Elise Jan

Fulsang, Elise Jan is an individual health care provider with primary practice located at 300 N Graham St Suite 200, Portland OR 97227-1683. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Fulsang, Elise Jan can be contacted via phone (503) 413-4134.

Contact Information

Primary practice address
300 N Graham St Suite 200 Portland OR 97227-1683
Phone: (503) 413-4134
Fax: (503) 413-1895
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD23553 Oregon

Profile Details

NPI number 1952305385
LBN Legal business name Fulsang, Elise Jan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Apr 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952305385 NPPES
Oregon MEDICAID 232402

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