Individual
TAKEHIKO YAMAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(909) 793-1233
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12412
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225X00000X
—
CA
Enumeration date
04/16/2018
Last updated
04/16/2018
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