Provider Demographics
NPI:1487832150
Name:FERDER, FRAN DIANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRAN
Middle Name:DIANE
Last Name:FERDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:GLENEDEN BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97388-0069
Mailing Address - Country:US
Mailing Address - Phone:541-764-2980
Mailing Address - Fax:541-764-2982
Practice Address - Street 1:7755 HWY 101 SUITE A2A
Practice Address - Street 2:
Practice Address - City:GLENEDEN BEACH
Practice Address - State:OR
Practice Address - Zip Code:97388
Practice Address - Country:US
Practice Address - Phone:541-764-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0928103TC0700X
WA1111103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical