Wolf, Fawn Melanie

Wolf, Fawn Melanie is an individual health care provider with primary practice located at 9155 Sw Bernes Rd. Suite 638, Portland OR 97225. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is her primary health care specialty. Wolf, Fawn Melanie can be contacted via phone (503) 216-7000.

Contact Information

Primary practice address
9155 Sw Bernes Rd. Suite 638 Portland OR 97225
Phone: (503) 216-7000
Fax: (503) 216-6940
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD25195 Oregon
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X MD25195 Oregon

Profile Details

NPI number 1689636557
LBN Legal business name Wolf, Fawn Melanie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Mar 25th, 2021 - about 5 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 1689636557 NPPES
Oregon MEDICAID 277859

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