Individual
DEANDRE FRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
3910 SE STARK ST, PORTLAND, OR 97214-3241
(503) 802-0598
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
14-CRM-009
OR
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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