Organization
THE WELLNESS COOPERATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA LEE FREDERICK APRN (FOUNDING MEMBER, FNP-C)
(503) 791-2816
Entity
Organization
Contact information
Practice address
714 HARRISON AVE, ASTORIA, OR 97103-4738
(503) 791-2816
(866) 638-1928
Mailing address
714 HARRISON AVE, ASTORIA, OR 97103-4738
(503) 791-2816
(866) 638-1928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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