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General NPI Number Information
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NPI Number | 1073194833
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Entity Type | Individual
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Provider Name | KYLE KAZUHARU YOSHIOKA LAC
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Gender | Male
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 1100 SE 12TH AVE APT 206
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City | PORTLAND
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State | OR
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Zip | 97214-3796
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Country | US
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Telephone | 541-371-5919
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 SE 12TH AVE APT 206
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City | PORTLAND
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State | OR
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Zip | 97214-3796
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Country | US
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Telephone | 541-371-5919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC203458
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License Number State | OR
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