Basic Information
Provider Information
NPI: 1235240441
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OKEN
FirstName: STUART
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: KAISER PERMANENTE BEAVERTON MEDICAL OFFICE
Address2: 4855 SW WESTERN AVE
City: BEAVERTON
State: OR
PostalCode: 97005
CountryCode: US
TelephoneNumber: 5032493434
FaxNumber:  
Practice Location
Address1: KAISER PERMANENTE BEAVERTON MEDICAL OFFICE
Address2: 4855 SW WESTERN AVE
City: BEAVERTON
State: OR
PostalCode: 970053460
CountryCode: US
TelephoneNumber: 5032493434
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 07/12/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XMD11166ORY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home