Healthcare Provider Details

I. General information

NPI: 1346253887
Provider Name (Legal Business Name): FRANK DAVENPORT EIGNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 7TH AVE
LONGVIEW WA
98632-3166
US

IV. Provider business mailing address

8906 NW LAKESHORE AVE
VANCOUVER WA
98665-6527
US

V. Phone/Fax

Practice location:
  • Phone: 360-575-4801
  • Fax:
Mailing address:
  • Phone: 360-571-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00023307
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD14724
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: