Individual
FREDA BRIGITTE BAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
847 NE 19TH AVE STE 150, PORTLAND, OR 97232-2686
(502) 232-1670
(503) 764-9646
Mailing address
847 NE 19TH AVE STE 150, PORTLAND, OR 97232-2686
(503) 232-1670
(503) 764-9646
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1568
OR
103TH0100X
Health Service Psychologist
1568
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029055
—
OR
05
—
500655961
—
OR
Enumeration date
07/27/2006
Last updated
06/02/2023
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