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Individual

MS. JANELLE KATE FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-4661
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239
(503) 494-7246
(503) 494-8368

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
CRNA-01251
NM
367500000X
Certified Registered Nurse Anesthetist
Primary
201407791CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
AP61028430
WA
367500000X
Certified Registered Nurse Anesthetist
RN615293
PA

Other

Enumeration date
11/19/2012
Last updated
01/23/2024
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