Individual
ELYJAH JONATHAN M FRITZ-RAFAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSS, CRM II, CADC-I
Contact information
Practice address
3231 SE 50TH AVE, PORTLAND, OR 97206-2248
(503) 238-5203
Mailing address
3231 SE 50TH AVE, PORTLAND, OR 97206-2248
(503) 238-5203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25-02-11404
OR
Other
Enumeration date
01/05/2023
Last updated
03/12/2025
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