FREDERICK BERRY

PORTLAND, OR
NPI1194147223
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-01-08
Last Update Date2014-01-08
Business Address
-- FREDERICK BERRY
3034 NE MLK BLVD
PORTLAND, OR 97212-3053
Phone number: 503-238-3763
Mailing Address
-- FREDERICK BERRY
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769