Provider Demographics
NPI:1316048887
Name:MOSSMAN, FRANK ROBERTS (OD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:ROBERTS
Last Name:MOSSMAN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 HAZELDELL AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665
Mailing Address - Country:US
Mailing Address - Phone:360-693-8598
Mailing Address - Fax:360-693-7523
Practice Address - Street 1:7600 HAZELDELL AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665
Practice Address - Country:US
Practice Address - Phone:360-693-8598
Practice Address - Fax:360-693-7523
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA735152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2074003Medicaid
U29840Medicare UPIN