Provider Demographics
NPI:1336781202
Name:MURATA, COURTNEY RAE
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:MURATA
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 1:337 NW 215TH TERRACE
Mailing Address - Street 2:APT, 106
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006
Mailing Address - Country:US
Mailing Address - Phone:209-403-8596
Mailing Address - Fax:
Practice Address - Street 1:337 NW 215TH TERRACE
Practice Address - Street 2:APT, 106
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006
Practice Address - Country:US
Practice Address - Phone:209-403-8596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician