Provider Demographics
NPI:1356857254
Name:HUSTON, FRANK E
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:E
Last Name:HUSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 SE ELM ST
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:OR
Mailing Address - Zip Code:97115-9617
Mailing Address - Country:US
Mailing Address - Phone:217-891-4266
Mailing Address - Fax:
Practice Address - Street 1:1525 SW SHIRLEY ANN DR
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-7665
Practice Address - Country:US
Practice Address - Phone:503-472-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health