Individual
PRESTON RAY FRASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 E HEREFORD ST, GLADSTONE, OR 97027-2165
(503) 656-0393
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63387
OR
225100000X
Physical Therapist
63887
OR
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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