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General NPI Number Information
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NPI Number | 1972925014
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Entity Type | Organization
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Legal Business Name | MELINDA FRANK, LAC, LLC
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Dates
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Enumeration Date | 01/08/2014
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 12250 SW 2ND ST
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City | BEAVERTON
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State | OR
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Zip | 97005-2828
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Country | US
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Telephone | 503-970-7395
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Fax |
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Provider Business Mailing Address
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Address Line | 12875 SW DEER OAK LN
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City | BEAVERTON
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State | OR
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Zip | 97008-1000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MELINDA FRANK
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Credential | LAC
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Telephone | 503-970-7395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC161487
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License Number State | OR
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