Individual
KEVIE KAWASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
14740 NW CORNELL RD STE 110, PORTLAND, OR 97229-5400
(503) 645-8002
Mailing address
PO BOX 956, BANDON, OR 97411-0956
(541) 347-3622
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4462
OR
Other
Enumeration date
06/10/2019
Last updated
07/01/2021
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