Individual
DEBRA FRESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 238-2067
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11-09-16
OR
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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