Provider Demographics
NPI:1225293988
Name:FRITZ, VANESSA (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 SE MORRISON ST STE 207
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-6303
Mailing Address - Country:US
Mailing Address - Phone:503-239-1022
Mailing Address - Fax:503-512-5850
Practice Address - Street 1:516 SE MORRISON ST STE 207
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6303
Practice Address - Country:US
Practice Address - Phone:503-239-1022
Practice Address - Fax:503-512-5850
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1626175F00000X
ORAC160693171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist