Individual
DR. JULIE D. FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9900 SW WILSHIRE ST, SUITE 160, PORTLAND, OR 97225-5035
(503) 894-9255
(503) 385-0343
Mailing address
9900 SW WILSHIRE ST, SUITE 160, PORTLAND, OR 97225-5035
(503) 894-9255
(503) 385-0343
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1006
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035142
—
OR
Enumeration date
11/08/2005
Last updated
06/22/2015
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