Individual
KERNAN ROBERT FRITSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(866) 523-4268
(510) 900-4310
Mailing address
DEPT LA 22763, PASADENA, CA 91185-0001
(866) 523-4268
(510) 900-4310
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
10232407
OR
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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