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General NPI Number Information
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NPI Number | 1730574880
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Entity Type | Individual
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Provider Name | KEIICHI AOYAMA DC, MS
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Gender | Male
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Dates
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Enumeration Date | 04/04/2015
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 10700 SW BEAVERTON HILLSDALE HWY STE 113
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City | BEAVERTON
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State | OR
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Zip | 97005-3035
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Country | US
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Telephone | 503-941-5465
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Fax | 503-765-1925
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Provider Business Mailing Address
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Address Line | 10700 SW BEAVERTON HILLSDALE HWY STE 113
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City | BEAVERTON
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State | OR
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Zip | 97005-3035
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Country | US
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Telephone | 503-941-5465
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Fax | 503-765-1925
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5634
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License Number State | OR
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