Miyasato, Kevin C.

Miyasato, Kevin C. is an sole proprietor health care provider with primary practice located at 12725 Sw Millikan Way Suite 300, Beaverton OR 97005-1678. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Miyasato, Kevin C. can be contacted via phone (503) 906-7870.

Contact Information

Primary practice address
12725 Sw Millikan Way Suite 300 Beaverton OR 97005-1678
Phone: (503) 906-7870
Fax: (503) 906-7871
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 00686 Nevada
Behavioral Health & Social Service Providers / Clinical 1041C0700X 5214-S Nevada
Behavioral Health & Social Service Providers / Clinical 1041C0700X 5855 Oregon

Profile Details

NPI number 1184902504
LBN Legal business name Miyasato, Kevin C.
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2011
Last updated Jun 6th, 2014 - about 12 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 1184902504 NPPES
Oregon MEDICAID 500670052

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