Provider Demographics
NPI:1316618481
Name:MURAMOTO, KATE (OD)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:MURAMOTO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 SE 41ST LOOP
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7541
Mailing Address - Country:US
Mailing Address - Phone:818-836-9555
Mailing Address - Fax:
Practice Address - Street 1:200 N ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1769
Practice Address - Country:US
Practice Address - Phone:310-385-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORATI4600152W00000X
CA35072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist