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1255536181

NPI Code Detail

MEDICARE: DR. CYRIL KURIAKOSE MD

MEDICARE: DR. CYRIL KURIAKOSE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	MD60279943	WA
2	207RN0300X	Nephrology Physician	MD209095	OR
3	207RN0300X	Nephrology Physician	ME115421	FL
4	207RN0300X	Nephrology Physician	MED-PHYS-COM-LIC-145	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	EIN	OTHER	FL	591561574
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255536181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYRIL KURIAKOSE MD

Provider Business Mailing Address
First Line	:	1130 NW 22ND AVE STE 640
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-5488
Country	:	US
Telephone Number	:	503-229-7976
Fax Number	:	503-274-4867

Provider Business Practice Location Address
First Line	:	19300 SW 65TH AVE
Second Line	:
City	:	TUALATIN
State	:	OR
Zip	:	97062-7706
Country	:	US
Telephone Number	:	503-692-1212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	03/30/2026

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Directions to “ DR. CYRIL KURIAKOSE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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