Mr. Edward Frazier Sirchuk Sr.
Mr. Edward Frazier Sirchuk Sr. is a PACE Provider Organization in Harbor, Oregon. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
- Specialties on file
- 2
Practice location Address checks out
15957 Highway 101 S Ste 11Harbor, OR 97415-8507
Phone: (541) 813-9142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X |
|---|---|
| PACE Provider Organization | Taxonomy 251T00000X |
Record details
| NPI number | 1851107635 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | December 6, 2024 |
| Last updated in NPPES | December 7, 2024 |
| Certification date | December 7, 2024 |