Provider Demographics
NPI:1538501580
Name:ASAOKA, RITA ADELE (LMT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:ADELE
Last Name:ASAOKA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 SW ROXBURY AVE
Mailing Address - Street 2:4
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5157
Mailing Address - Country:US
Mailing Address - Phone:503-858-4909
Mailing Address - Fax:
Practice Address - Street 1:2301 NW THURMAN ST
Practice Address - Street 2:SUITE Q
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2581
Practice Address - Country:US
Practice Address - Phone:503-858-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19588225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist