Provider Demographics
NPI:1356569594
Name:FRANDANISA, JAMES ANGELO (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANGELO
Last Name:FRANDANISA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 LAKEWOOD DR W STE A2
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98467-3299
Mailing Address - Country:US
Mailing Address - Phone:253-582-2122
Mailing Address - Fax:
Practice Address - Street 1:6915 LAKEWOOD DR W STE A2
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98467-3299
Practice Address - Country:US
Practice Address - Phone:253-582-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHOOOO2876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8805251Medicare ID - Type Unspecified
WAU42308Medicare UPIN