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Individual

MR. DONALD DARYL FREDERICKSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
1727 RIDGEVIEW DR, CLARKSTON, WA 99403-3073
(509) 780-2111
Mailing address
1727 RIDGEVIEW DR, CLARKSTON, WA 99403-3073
(509) 780-2111

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT665
ID

Other

Enumeration date
09/05/2013
Last updated
09/05/2013
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