Individual
MAKOTO UCHIYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
19300 SW 65TH AVE, TUALATIN, OR 97062-7706
(503) 413-8407
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A16274
CA
207R00000X
Internal Medicine Physician
OP60802412
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
DO161382
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500659840
—
OR
Enumeration date
05/03/2010
Last updated
02/11/2021
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