ALISE FAIRCLOTH

NPI: 1801262589 · Individual · Active

Primary Specialty

Contractor

Practice Location

1921 SW 144TH AVE
BEAVERTON, OR 97005-2356 Map ↗
Phone: 503-704-6982

All Specialties & Licenses

  • Contractor Primary (license: 21439, OR)

NPI Registration

Enumerated: 2015-08-17

Last CMS Update: 2015-08-17