Kuriakose, Dana Clark

Kuriakose, Dana Clark is an individual health care provider with primary practice located at 17885 Nw Evergreen Pkwy , Beaverton OR 97006-7494. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Kuriakose, Dana Clark can be contacted via phone (888) 414-3531.

Contact Information

Primary practice address
17885 Nw Evergreen Pkwy Beaverton OR 97006-7494
Phone: (888) 414-3531
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X ME119316 Florida
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD209098 Oregon

Profile Details

NPI number 1760619357
LBN Legal business name Kuriakose, Dana Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2009
Last updated Oct 19th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760619357 NPPES
Florida MEDICAID 014589800

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