Individual
ANDREW FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4411 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 494-9992
(503) 494-1967
Mailing address
4411 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 494-9992
(503) 494-1967
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA184554
OR
Other
Enumeration date
06/01/2016
Last updated
11/11/2021
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