Doctor Name: | KAREN AIKO MIYAZONO |
NPI Number: | 1720120975 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 5901 |
Business Practice Address: | 15240 Se 82nd Dr Clackamas, OR - 970159606 |
Business Phone Number: | 5036565510 |
Business Fax Number: | |
Mailing Address: | 4121 Se 73rd Ave, PORTLAND |
State: | OR |
Postal Code: | 972063403 |
Phone Number: | 5037306232 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 5901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |