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Individual

JULIA ALICE FREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, GH219, PORTLAND, OR 97239-3011
(503) 494-3633
Mailing address
3181 SW SAM JACKSON PARK RD # BTE119, PORTLAND, OR 97239-3098

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA164906
OR
363AM0700X
Medical Physician Assistant
Primary
PA164906
OR

Other

Enumeration date
02/01/2012
Last updated
12/18/2020
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