Individual
DR. SUSAN Y KUBOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8983 SW ARAPAHO RD, TUALATIN, OR 97062-9355
(503) 330-0477
Mailing address
8983 SW ARAPAHO RD, TUALATIN, OR 97062-9355
(503) 330-0477
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD17827
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050073777
RR MEDICARE
OR
05
—
134370
—
OR
05
—
805347000
—
ID
05
—
8175911
—
WA
05
—
MD782OR
—
AK
Enumeration date
07/26/2006
Last updated
05/01/2017
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