Provider Demographics
NPI:1851758429
Name:OYAMA LLC
Entity Type:Organization
Organization Name:OYAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-364-4710
Mailing Address - Street 1:17833 40TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-4201
Mailing Address - Country:US
Mailing Address - Phone:206-364-4710
Mailing Address - Fax:
Practice Address - Street 1:6300 9TH AVE NE STE 109
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8516
Practice Address - Country:US
Practice Address - Phone:206-364-4710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60561574175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty