Provider Demographics
NPI:1609166941
Name:LAO, RITHEA NONE I (030396)
Entity Type:Individual
Prefix:MR
First Name:RITHEA
Middle Name:NONE
Last Name:LAO
Suffix:I
Gender:M
Credentials:030396
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6196 NICKLAUS LOOP N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-7541
Mailing Address - Country:US
Mailing Address - Phone:503-856-4166
Mailing Address - Fax:
Practice Address - Street 1:6196 NICKLAUS LOOP N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-7541
Practice Address - Country:US
Practice Address - Phone:503-856-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter