Provider Demographics
NPI:1417103037
Name:OREGON COLLEGE OF ORIENTAL MEDICINE
Entity Type:Organization
Organization Name:OREGON COLLEGE OF ORIENTAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN OF CLINICS
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KANEKO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-253-3443
Mailing Address - Street 1:10541 SE CHERRY BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2826
Mailing Address - Country:US
Mailing Address - Phone:503-253-3443
Mailing Address - Fax:503-251-2092
Practice Address - Street 1:10541 SE CHERRY BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2826
Practice Address - Country:US
Practice Address - Phone:503-253-3443
Practice Address - Fax:503-251-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty