Provider Demographics
NPI:1437773298
Name:CAPOBIANCO, FRANK (CPT)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:CAPOBIANCO
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6464 SW BORLAND RD STE C5
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8856
Mailing Address - Country:US
Mailing Address - Phone:503-878-5418
Mailing Address - Fax:888-972-9515
Practice Address - Street 1:6464 SW BORLAND RD STE C5
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8856
Practice Address - Country:US
Practice Address - Phone:503-878-5418
Practice Address - Fax:888-972-9515
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT19-7627246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy