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General NPI Number Information
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NPI Number | 1013211739
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Entity Type | Organization
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Legal Business Name | JAMES H IMATANI, JR. M.D., PC
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 5050 NE HOYT ST SUITE 610
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City | PORTLAND
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State | OR
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Zip | 97213-2944
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Country | US
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Telephone | 503-467-4761
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Fax | 503-467-6766
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Provider Business Mailing Address
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Address Line | 5050 NE HOYT ST SUITE 610
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City | PORTLAND
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State | OR
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Zip | 97213-2944
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Country | US
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Telephone | 503-467-4761
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Fax | 503-467-6766
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JAMES H IMATANI
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Credential | MD
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Telephone | 503-467-4761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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