Individual
SKYLAR KIMI NAKATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2205 NE COLUMBIA BLVD STE E, PORTLAND, OR 97211-1930
(503) 895-1320
Mailing address
2205 NE COLUMBIA BLVD STE E, PORTLAND, OR 97211-1930
(503) 895-1320
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
65460
OR
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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