Provider Demographics
NPI:1780637363
Name:WARREN, FRANK MANLEY III (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MANLEY
Last Name:WARREN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:541 NE 20TH AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2895
Mailing Address - Country:US
Mailing Address - Phone:503-963-2801
Mailing Address - Fax:503-963-2825
Practice Address - Street 1:9155 SW BARNES RD STE 536
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6785
Practice Address - Country:US
Practice Address - Phone:503-935-8100
Practice Address - Fax:503-935-8110
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD28998207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1780637363Medicaid
OR500621266Medicaid
OR500621266Medicaid
OR175142Medicare PIN