Individual
CYNTHIA A FRADL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
L5766
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500656288
—
OR
Enumeration date
01/19/2012
Last updated
03/17/2022
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