Healthcare Provider Details

I. General information

NPI: 1437742434
Provider Name (Legal Business Name): JUSTIN FRANK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 E BROADWAY STE 431
EUGENE OR
97401-3158
US

IV. Provider business mailing address

2815 MELVILLE WAY APT 105
EUGENE OR
97408-7446
US

V. Phone/Fax

Practice location:
  • Phone: 541-390-4559
  • Fax:
Mailing address:
  • Phone: 541-513-7739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPROFESSIONALLICENSE
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: