Provider Demographics
NPI:1699958926
Name:AVERSANO, FRANK GARY (ND)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:GARY
Last Name:AVERSANO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
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Mailing Address - Street 1:400 MERCER ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4650
Mailing Address - Country:US
Mailing Address - Phone:206-448-1906
Mailing Address - Fax:206-352-5602
Practice Address - Street 1:400 MERCER ST
Practice Address - Street 2:SUITE 302
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4650
Practice Address - Country:US
Practice Address - Phone:206-448-1906
Practice Address - Fax:206-352-5602
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WANT00000989208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice