Active NPI
Annalisa Fredrickson
- Professional Counselor
- Portland, OR
National Provider Identifier
1730901646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 7412 SW Beaverton Hillsdale Hwy Ste 106
Portland, OR 97225-2167 - Phone
- (503) 530-8521
- NPI assigned
- Oct 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
7412 SW Beaverton Hillsdale Hwy Ste 106
Portland, OR 97225-2167
Mailing address
7412 SW Beaverton Hillsdale Hwy
Portland, OR 97225-2162
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1730901646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7412 SW BEAVERTON HILLSDALE HWY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972252162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7412 SW BEAVERTON HILLSDALE HWY STE 106",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972252167",
"telephone_number": "503-530-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDRICKSON",
"first_name": "ANNALISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-30",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.