Individual
MR. BRADLEY STEVEN FRUIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA
Contact information
Practice address
55 SE GRAND AVE, PORTLAND, OR 97232
(503) 954-4452
Mailing address
1080 MARINA VILLAGE PKWY, SUITE 100, ALAMEDA, CA 94501-6427
(503) 954-4452
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/08/2011
Last updated
03/15/2018
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