Provider Demographics
NPI:1356328959
Name:GEMMATO, FRANK (LAC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:GEMMATO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 SE 32ND AVE
Mailing Address - Street 2:#120
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6587
Mailing Address - Country:US
Mailing Address - Phone:503-659-8900
Mailing Address - Fax:503-659-8906
Practice Address - Street 1:10330 SE 32ND AVE
Practice Address - Street 2:#120
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6587
Practice Address - Country:US
Practice Address - Phone:503-659-8900
Practice Address - Fax:503-659-8906
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022583OtherOMAP