Individual
SAIE KURAKULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LE
Contact information
Practice address
333 NE HANCOCK ST, PORTLAND, OR 97212-3941
(818) 795-2450
Mailing address
1115 NE 114TH AVE UNIT A, PORTLAND, OR 97220-2252
(818) 795-2450
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAP-E-10255940
OR
Other
Enumeration date
06/16/2025
Last updated
07/07/2025
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