Fry, David James

Fry, David James is an sole proprietor health care provider with primary practice located at 3425 13Th St , Baker City OR 97814-1340. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Fry, David James can be contacted via phone (541) 523-7400.

Contact Information

Primary practice address
3425 13Th St Baker City OR 97814-1340
Phone: (541) 523-7400
Fax: (541) 523-4927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X 24-QMHA-R-4832 Oregon
Other Service Providers / Peer Specialist 175T00000X 23-CRM-2394 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15-04-21 Oregon

Profile Details

NPI number 1982043642
LBN Legal business name Fry, David James
Credentials CADC I
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2013
Last updated Jan 19th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982043642 NPPES
Oregon MEDICAID CGAC-RTG-22-097
Oregon MEDICAID 500699844

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