Individual
MR. BRENT FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-2000
(866) 404-1777
Mailing address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-2000
(866) 404-1777
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0008650
OR
Other
Enumeration date
10/06/2016
Last updated
10/11/2016
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