FRED MCLANE BRUDERLIN

PORTLAND, OR
NPI1275041436
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Additional Taxonomies172V00000X Community Health Worker
Enumeration Date2018-01-22
Last Update Date2018-01-22
Business Address
FRED MCLANE BRUDERLIN
5211 NE GLISAN ST BLDG C
PORTLAND, OR 97213-3052
Phone number: 503-704-6658
Mailing Address
FRED MCLANE BRUDERLIN
515 ATWATER RD
LAKE OSWEGO, OR 97034-2115
Phone number: 503-704-6658
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