Raelin Fullmer I

NPI #1528487956 in Tualatin, Oregon

Provider Information

NPI Number: 1528487956
Entity Type: Individual
Name: Raelin Fullmer I
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Internal Medicine
Enumeration Date: Apr 14, 2014
Last Updated: Aug 21, 2019

Practice Location

Address: 19300 SW 65TH AVE
City: Tualatin
State: Oregon
ZIP Code: 97062
Phone: (503) 413-8407

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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