FREDRICK AN

GRESHAM, OR
NPI1194991901
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: OR  DO29350)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2008-05-01
Last Update Date2020-12-04
Business Address
FREDRICK AN
24800 SE STARK ST
GRESHAM, OR 97030-3378
Phone number: 503-413-8407
Mailing Address
FREDRICK AN
24800 SE STARK ST
GRESHAM, OR 97030-3378
Phone number: 503-413-8407