Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003207143 |
---|---|
Provider Name | Carolyn Frank |
First Address | Beaverton, OR 97005-2512 |
Second Address | Beaverton, OR 97005-2512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2015 |
Last Update Date | 11/02/2015 |