Sydney Fredrickson

Individual provider Active NPI Professional Counselor · Estacada, OR

NPI 1417547142 · NPPES record last updated Sep 30, 2025

Key facts

NPI
1417547142
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
112 NE Oak View LN
Estacada, OR 97023-9357
Phone
(520) 490-4647
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

112 NE Oak View LN
Estacada, OR 97023-9357

Mailing address

112 NE Oak View LN
Estacada, OR 97023-9357
Phone (520) 490-4647

Other providers in Estacada, OR

All providers in Estacada, OR · Professional Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.