Provider Demographics
NPI:1801049465
Name:DUNLAP, HARUKI (LMT)
Entity type:Individual
Prefix:MR
First Name:HARUKI
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:MS
Other - First Name:VERONICA
Other - Middle Name:FUMIE
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 1624
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97075
Mailing Address - Country:US
Mailing Address - Phone:971-340-8860
Mailing Address - Fax:
Practice Address - Street 1:5215 NE ELAM YOUNG PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124
Practice Address - Country:US
Practice Address - Phone:503-693-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14459171W00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171W00000XOther Service ProvidersContractor