Provider Demographics
NPI:1720114002
Name:SUZUKI, AIJIRO P (MD)
Entity Type:Individual
Prefix:DR
First Name:AIJIRO
Middle Name:P
Last Name:SUZUKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28130
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97228-8130
Mailing Address - Country:US
Mailing Address - Phone:503-681-1000
Mailing Address - Fax:503-681-1796
Practice Address - Street 1:335 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4246
Practice Address - Country:US
Practice Address - Phone:503-681-1109
Practice Address - Fax:503-681-1835
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26160174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213384Medicaid
OR213384Medicaid
ORP00733975Medicare PIN
OR132688Medicare PIN
ORR147311Medicare PIN