Healthcare Provider Details

I. General information

NPI: 1336060201
Provider Name (Legal Business Name): KAREN MICHELE FRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 NW DOGWOOD AVE
REDMOND OR
97756-1671
US

IV. Provider business mailing address

1841 SW 21ST ST APT A
REDMOND OR
97756-8452
US

V. Phone/Fax

Practice location:
  • Phone: 541-904-5086
  • Fax:
Mailing address:
  • Phone: 541-904-5086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: