Provider Demographics
NPI:1598873028
Name:MURAKI, CECILIA SAQUETON (OD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:SAQUETON
Last Name:MURAKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:MERCEDES
Other - Last Name:SAQUETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2505 NE 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1923
Mailing Address - Country:US
Mailing Address - Phone:503-493-0026
Mailing Address - Fax:
Practice Address - Street 1:3600 N INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1106
Practice Address - Country:US
Practice Address - Phone:503-285-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2577T152W00000X
WAOD00003267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist