Provider Demographics
NPI:1679258727
Name:FRASCONE, CHRISTIANA LEE (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIANA
Middle Name:LEE
Last Name:FRASCONE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 NEAL AVE N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-9609
Mailing Address - Country:US
Mailing Address - Phone:651-785-5231
Mailing Address - Fax:
Practice Address - Street 1:3857 WOLVERINE ST NE # 16-C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-4270
Practice Address - Country:US
Practice Address - Phone:503-877-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR31709231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist