=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780637363
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANK MANLEY WARREN III M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2006
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1815 SW MARLOW AVE STE 100
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97225-5185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-935-8100
-----------------------------------------------------
Fax | 503-935-8110
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 541 NE 20TH AVE STE 225
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97232-2895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-963-2801
-----------------------------------------------------
Fax | 503-963-2825
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207YX0901X
-----------------------------------------------------
Taxonomy Name | Otology & Neurotology Physician
-----------------------------------------------------
License Number | MD28998
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------