Provider Demographics
NPI:1952478398
Name:HOSOYAMADA, NORIKO (LAC)
Entity Type:Individual
Prefix:MS
First Name:NORIKO
Middle Name:
Last Name:HOSOYAMADA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 SE 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1601
Mailing Address - Country:US
Mailing Address - Phone:360-737-1940
Mailing Address - Fax:360-737-1940
Practice Address - Street 1:2526 NE 15TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-4222
Practice Address - Country:US
Practice Address - Phone:503-288-7668
Practice Address - Fax:503-288-8972
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00684171100000X
WAAC00002222171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist