Poonyagariyagorn, Hataya Kristy
Poonyagariyagorn, Hataya Kristy is an individual health care provider with primary practice located at 9427 Sw Barnes Rd Ste 296 , Portland OR 97225-6667. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Poonyagariyagorn, Hataya Kristy can be contacted via phone (503) 297-3778.Contact Information
Primary practice address
9427 Sw Barnes Rd Ste 296
Portland OR 97225-6667
Phone: (503) 297-3778
Fax: (503) 297-7853
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | MD161977 | Oregon |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | MD161977 | Oregon |
Profile Details
| NPI number | 1720264476 |
|---|---|
| LBN Legal business name | Poonyagariyagorn, Hataya Kristy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2008 |
| Last updated | Dec 5th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720264476 | NPPES |
| Washington | MEDICAID | 2029616 | |
| Washington | MEDICAID | 500657789 |
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