Individual
DR. JOHN FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC, CAS
Contact information
Practice address
450 5TH ST, SUITE E, LAKE OSWEGO, OR 97034-3059
(503) 343-5666
Mailing address
450 5TH ST, SUITE E, LAKE OSWEGO, OR 97034-3059
(503) 343-5666
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C-1322
OR
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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