Healthcare Provider Details

I. General information

NPI: 1235240441
Provider Name (Legal Business Name): STUART LEE OKEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KAISER PERMANENTE BEAVERTON MEDICAL OFFICE 4855 SW WESTERN AVE
BEAVERTON OR
97005-3460
US

IV. Provider business mailing address

KAISER PERMANENTE BEAVERTON MEDICAL OFFICE 4855 SW WESTERN AVE
BEAVERTON OR
97005
US

V. Phone/Fax

Practice location:
  • Phone: 503-249-3434
  • Fax:
Mailing address:
  • Phone: 503-249-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD11166
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: