Individual
DR. FRED M GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
416 NW 13TH AVE, #210, PORTLAND, OR 97209-2931
(503) 525-4436
Mailing address
416 NW 13TH AVE, #210, PORTLAND, OR 97209-2931
(503) 525-4436
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
956
OR
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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