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Individual

CRYSTAL MIYAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSCCCA

Contact information

Practice address
3099 RIVER RD S, STE 150, SALEM, OR 97302-9754
(503) 485-2581
(503) 485-2564
Mailing address
3099 RIVER RD S, STE 150, SALEM, OR 97302-9754
(503) 485-2581
(503) 485-2564

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
022558
OR
231H00000X
Audiologist
LD00004248
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
270845
OR
Enumeration date
06/01/2006
Last updated
03/23/2016
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