Individual
MANAMI FURUYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5 CENTERPOINTE DR, SUITE 600, LAKE OSWEGO, OR 97035-8651
(503) 444-0556
Mailing address
5439 NW SKYCREST PKWY, PORTLAND, OR 97229-2306
(503) 310-7535
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200040575RN
OR
163W00000X
Registered Nurse
RN60180981
WA
363L00000X
Nurse Practitioner
AP60180982
WA
363LF0000X
Family Nurse Practitioner
Primary
200850101NP FNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R181408
PTAN
—
Enumeration date
07/31/2007
Last updated
03/17/2018
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