Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | LL16607 | OR |
NPI | 1124236021 |
---|---|
Provider Name | Juha Pekka Rasanen |
First Address | Lake Oswego, OR 97034-7346 |
Second Address | Portland, OR 97239-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
247329 | (05) | OR |
807594900 | (05) | ID |
8466294 | (05) | WA |
93125743797239A739 | TRIWEST (01) | OR |