Individual
ERIC JAMES FREDERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
835 SW 11TH ST, NEWPORT, OR 97365-4802
(541) 265-5356
Mailing address
4330 SE FLEMING ST, NEWPORT, OR 97366-9692
(707) 880-2364
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10046143
OR
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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