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Individual

JAMES KIRK FRYMIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7511 SE HENRY ST, PORTLAND, OR 97206-6445
(503) 771-6061
Mailing address
7511 SE HENRY ST, PORTLAND, OR 97206-6445
(503) 771-6061

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
NONE
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SR-3
HEALTHNET
PA
Enumeration date
10/24/2007
Last updated
10/24/2007
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