Individual
AMANDA KRISTINE FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
3611 SE 64TH AVE., PORTLAND, OR 97206
(503) 494-8300
Mailing address
3611 SE 64TH AVE., PORTLAND, OR 97206
(503) 494-8300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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