Search › Oregon › 172V00000X
Fred Bruderlin
NPI 1275041436 · on the registry since 2018 · sole proprietor
Practice
- Address
- 5211 Ne Glisan St Bldg C
Portland, OR 97213 - Phone
- (503) 704-6658
- Organisation at this address
- Providence Health & Services Oregon
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 27
Registry record
- Primary taxonomy
- 172V00000X
172V00000X
- Also registered as
- 172V00000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-01-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon