Individual
DR. DANA CLARK KURIAKOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17885 NW EVERGREEN PKWY, BEAVERTON, OR 97006-7494
(888) 414-3531
Mailing address
PO BOX 96224, PORTLAND, OR 97296-6004
(908) 303-2105
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD209098
OR
208100000X
Physical Medicine & Rehabilitation Physician
ME119316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014589800
—
FL
Enumeration date
06/22/2009
Last updated
10/19/2023
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