Individual
KAREN AIKO MIYAZONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
15240 SE 82ND DR, CLACKAMAS, OR 97015-9606
(503) 656-5510
Mailing address
4121 SE 73RD AVE, PORTLAND, OR 97206-3403
(503) 730-6232
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5901
OR
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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