Provider Demographics
NPI:1538120621
Name:VOKOUN, PAULA F (RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:F
Last Name:VOKOUN
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 ROCKINGHORSE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-1657
Mailing Address - Country:US
Mailing Address - Phone:503-692-7617
Mailing Address - Fax:503-692-7788
Practice Address - Street 1:19300 SW 65TH AVE
Practice Address - Street 2:MERIDIAN PARK HOSPITAL DIABETES SERVICES
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7706
Practice Address - Country:US
Practice Address - Phone:503-692-7617
Practice Address - Fax:503-692-7788
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR249133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP64249Medicare UPIN
OR113820Medicare ID - Type Unspecified