Individual
RACHEL FREDERICKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-2759
(216) 213-0361
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(860) 659-7990
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.006720RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2020
Last updated
12/01/2022
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