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Individual

NOLA R FRASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1608 S 24TH AVE STE 102, YAKIMA, WA 98902-5719
(509) 248-6113
(509) 457-8941
Mailing address
1608 S 24TH AVE STE 102, YAKIMA, WA 98902-5719
(509) 248-6113
(509) 457-8941

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4797
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118096
OR
01
885802001
BLUE CROSS BLUE SHIELD
OR
Enumeration date
01/23/2006
Last updated
09/24/2015
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