Healthcare Provider Details

I. General information

NPI: 1134606049
Provider Name (Legal Business Name): TOSHIKI KUNO MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-1775
  • Fax: 503-494-4749
Mailing address:
  • Phone: 503-494-1775
  • Fax: 503-494-4749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD230235
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: