Individual
ERIC J FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AU.D
Contact information
Practice address
825 NE 20TH AVE, SUITE 230, PORTLAND, OR 97232-2275
(503) 928-4327
(503) 719-8209
Mailing address
10350 N VANCOUVER WAY, #236, PORTLAND, OR 97217-7530
(503) 928-4327
(503) 719-8209
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
21685
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084413
—
OR
01
—
1336177138
NPI
—
Enumeration date
06/29/2006
Last updated
09/16/2011
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