Provider Demographics
NPI:1770880759
Name:FRANK, PETER (LMT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:FRANK
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51579 COLUMBIA RIVER HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-8411
Mailing Address - Country:US
Mailing Address - Phone:971-285-6411
Mailing Address - Fax:503-543-3550
Practice Address - Street 1:51579 COLUMBIA RIVER HWY
Practice Address - Street 2:SUITE F
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-8411
Practice Address - Country:US
Practice Address - Phone:971-285-6411
Practice Address - Fax:503-543-3550
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17795225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist