Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Fred McLane Bruderlin Jr.

Individual provider Community Health Worker · NPI 1275041436

Fred McLane Bruderlin Jr. is a Community Health Worker in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

5211 NE Glisan St Bldg C
Portland, OR 97213-3052
Phone: (503) 704-6658
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X
Community Health Worker Taxonomy 172V00000X (OR)

Record details

NPI number1275041436
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 22, 2018
Last updated in NPPESJanuary 22, 2018

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