Individual
MR. TODD DOUGLAS FRARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1941 SW LAKE PL, GRESHAM, OR 97080-9798
(253) 709-0271
Mailing address
1941 SW LAKE PL, GRESHAM, OR 97080-9798
(253) 709-0271
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
8494
OR
Other
Enumeration date
01/22/2009
Last updated
11/10/2010
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