Individual
DR. KEEGAN CARLY FRITZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2403
Mailing address
2104 NE 53RD AVE, PORTLAND, OR 97213-2610
(503) 201-7962
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0011292
OR
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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