Provider Demographics
NPI:1760687446
Name:POU, KANYA
Entity Type:Individual
Prefix:MRS
First Name:KANYA
Middle Name:
Last Name:POU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16363 SW TIMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-7802
Mailing Address - Country:US
Mailing Address - Phone:503-649-2773
Mailing Address - Fax:
Practice Address - Street 1:3633 SE 35TH PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3370
Practice Address - Country:US
Practice Address - Phone:503-494-6142
Practice Address - Fax:503-494-6143
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator