Provider Demographics
NPI:1790800712
Name:FRANK, ANDREW D (MACOM, LAC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:D
Last Name:FRANK
Suffix:
Gender:M
Credentials:MACOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 SW BARBUR BLVD # 10 D
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5931
Mailing Address - Country:US
Mailing Address - Phone:503-310-3165
Mailing Address - Fax:
Practice Address - Street 1:10151 SW BARBUR BLVD # 10 D
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5931
Practice Address - Country:US
Practice Address - Phone:503-310-3165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00829171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist