Provider Demographics
NPI:1245776806
Name:TERAMURA-OUNE, KIMIKO (RPH)
Entity Type:Individual
Prefix:
First Name:KIMIKO
Middle Name:
Last Name:TERAMURA-OUNE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:TERAMURA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:728 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2626
Mailing Address - Country:US
Mailing Address - Phone:541-889-3390
Mailing Address - Fax:541-889-4488
Practice Address - Street 1:728 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2626
Practice Address - Country:US
Practice Address - Phone:541-889-3390
Practice Address - Fax:541-889-4488
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0008436183500000X
CA43319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist