Provider Demographics
NPI:1891799268
Name:MURAKAMI, ANN K (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:K
Last Name:MURAKAMI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:K
Other - Last Name:MURAKAMI-MCDERMOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:3939 NE HANCOCK ST
Mailing Address - Street 2:# 312
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-5321
Mailing Address - Country:US
Mailing Address - Phone:503-380-4197
Mailing Address - Fax:971-244-9111
Practice Address - Street 1:3939 NE HANCOCK ST
Practice Address - Street 2:# 312
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-5321
Practice Address - Country:US
Practice Address - Phone:503-380-4197
Practice Address - Fax:971-244-9111
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2016-07-20
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
OR1516103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR115193Medicare UPIN