Provider Demographics
NPI:1912338625
Name:HERB, FRANK CHRISTOPHER (PTA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:CHRISTOPHER
Last Name:HERB
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 SE INTERNATIONAL WAY
Mailing Address - Street 2:STE. 100
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222
Mailing Address - Country:US
Mailing Address - Phone:971-206-5200
Mailing Address - Fax:971-206-5203
Practice Address - Street 1:390 CHURCH ST.
Practice Address - Street 2:
Practice Address - City:SUBLIMITY
Practice Address - State:OR
Practice Address - Zip Code:97385
Practice Address - Country:US
Practice Address - Phone:503-769-3499
Practice Address - Fax:503-769-3569
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR08952225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant