Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | MD00045274 | WA |
Y | 207RN0300X | Nephrologist | MD24235 | OR |
NPI | 1013022425 |
---|---|
Provider Name | Dr. Scott Keola Miyake |
First Address | Milwaukie, OR 97267-2148 |
Second Address | Milwaukie, OR 97267-2148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 04/02/2022 |