Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 3146T | OR |
NPI | 1063403798 |
---|---|
Provider Name | Dr. Beth Toshiko Kinoshita |
First Address | Forest Grove, OR 97116-1756 |
Second Address | Forest Grove, OR 97116-1756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 24/08/2009 |