Provider Demographics
NPI:1093810541
Name:SEKIYA, UTAKO (MD)
Entity Type:Individual
Prefix:
First Name:UTAKO
Middle Name:
Last Name:SEKIYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NW LOVEJOY ST STE 404
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2865
Mailing Address - Country:US
Mailing Address - Phone:503-224-9588
Mailing Address - Fax:503-224-9583
Practice Address - Street 1:2525 NW LOVEJOY ST STE 404
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2865
Practice Address - Country:US
Practice Address - Phone:503-224-9588
Practice Address - Fax:503-224-9583
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD233912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H82348Medicare UPIN
H82348Medicare UPIN