Basic Information
| Provider Information | |||||||||
| NPI: | 1134385461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OKUNS | ||||||||
| FirstName: | WARREN | ||||||||
| MiddleName: | IKPOMOSA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3777 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972083777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034133900 | ||||||||
| FaxNumber: | 5034133710 | ||||||||
| Practice Location | |||||||||
| Address1: | 19875 SW 65TH AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TUALATIN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970628353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036927785 | ||||||||
| FaxNumber: | 5036922520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2008 | ||||||||
| LastUpdateDate: | 09/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | TRN12110 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD155468 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.