MEDICARE: HEATHER ANN FRUHLING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	200841714RN	OR

General Provider Information

NPI Number	:	1770731887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER ANN FRUHLING

Provider Business Mailing Address
First Line	:	2748 NW THURMAN ST.
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210
Country	:	US
Telephone Number	:	503-502-3352
Fax Number	:

Provider Business Practice Location Address
First Line	:	2748 NW THURMAN ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-2205
Country	:	US
Telephone Number	:	503-502-3352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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Directions to “ HEATHER ANN FRUHLING ” Practice Location

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