Provider Demographics
NPI:1881954626
Name:FRIEDRICH, THOMAS (ROLFER, LMT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:FRIEDRICH
Suffix:
Gender:M
Credentials:ROLFER, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 SAN CLEMENTE DR
Mailing Address - Street 2:SUITE D130
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1244
Mailing Address - Country:US
Mailing Address - Phone:415-496-5070
Mailing Address - Fax:
Practice Address - Street 1:3125 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2073
Practice Address - Country:US
Practice Address - Phone:503-758-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-28
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24482225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist