Individual
KRISTINE OKAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3940 SE BROOKLYN ST, PORTLAND, OR 97202-1627
(503) 267-6479
Mailing address
3940 SE BROOKLYN ST, PORTLAND, OR 97202-1627
(503) 267-6479
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
18240
OR
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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