Provider Demographics
NPI:1528119617
Name:AKASAKA, DIANE MARGARET (LAC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARGARET
Last Name:AKASAKA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17595 KELOK RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-6653
Mailing Address - Country:US
Mailing Address - Phone:503-419-6263
Mailing Address - Fax:
Practice Address - Street 1:17620 PILKINGTON RD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5361
Practice Address - Country:US
Practice Address - Phone:503-636-1729
Practice Address - Fax:503-636-9862
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist