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NPI Code Detail

MEDICARE: PAULA F VOKOUN RD, LD, CDE

MEDICARE: PAULA F VOKOUN RD, LD, CDE
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
1133V00000XRegistered Dietitian249OR

General Provider Information

NPI Number : 1538120621
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA F VOKOUN RD, LD, CDE
Provider Business Mailing Address
First Line : 1257 ROCKINGHORSE LN
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97034-1657
Country : US
Telephone Number : 503-692-7617
Fax Number : 503-692-7788
Provider Business Practice Location Address
First Line : 19300 SW 65TH AVE
Second Line : MERIDIAN PARK HOSPITAL DIABETES SERVICES
City : TUALATIN
State : OR
Zip : 97062-7706
Country : US
Telephone Number : 503-692-7617
Fax Number : 503-692-7788
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 07/08/2007

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