Healthcare Provider Details

I. General information

NPI: 1255746434
Provider Name (Legal Business Name): FRANK ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SW 6TH ST
GRESHAM OR
97080-9475
US

IV. Provider business mailing address

630 NE LAWRENCE AVE APT 15
PORTLAND OR
97232-2395
US

V. Phone/Fax

Practice location:
  • Phone: 503-726-3806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: