MEDICARE: DURETI A FELEMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	20122413RN	OR

General Provider Information

NPI Number	:	1588325930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DURETI A FELEMA

Provider Business Mailing Address
First Line	:	8754 SE OWEN DR
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-7408
Country	:	US
Telephone Number	:	503-703-4879
Fax Number	:

Provider Business Practice Location Address
First Line	:	8754 SE OWEN DR
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-7408
Country	:	US
Telephone Number	:	503-703-4879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2022
Last Update Date	:	01/07/2022

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Directions to “ DURETI A FELEMA ” Practice Location

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