Provider Demographics
NPI:1619266632
Name:MAKI, ERIK J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:J
Last Name:MAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-7660
Mailing Address - Fax:775-337-2271
Practice Address - Street 1:2874 N CARSON ST STE 300
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1683
Practice Address - Country:US
Practice Address - Phone:775-445-5500
Practice Address - Fax:775-888-0202
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
ORMD1576672085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program