Bradley Steven Fruit, MBA
Counselor in Portland, OR. Individual provider (NPI-1).
NPI number1447547518
StatusActive
Last updated in NPPESMar 15, 2018
Details
- NPI
- 1447547518
- Entity type
- Individual (NPI-1)
- Name
- Mr. Bradley Steven Fruit
- Credential
- MBA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2011
- Last updated
- Mar 15, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
55 Se Grand AvePortland, OR 97232
Phone 503-954-4452
Mailing address
1080 Marina Village PkwySuite 100
Alameda, CA 94501-6427
Phone 503-954-4452
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