Provider Demographics
NPI:1902334618
Name:FRALEY, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:FRALEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6326 ROBIN HOOD ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-4000
Mailing Address - Country:US
Mailing Address - Phone:503-990-6076
Mailing Address - Fax:503-991-5673
Practice Address - Street 1:6326 ROBIN HOOD ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-4000
Practice Address - Country:US
Practice Address - Phone:503-990-6076
Practice Address - Fax:503-991-5673
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver