Most Relevant Information
Provider Data
| NPI Number: | 1003647645 |
| Provider Name: | DANIEL SCOTT KOSKENMAKI |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/13/2024 |
| Last Updated: | 08/13/2024 |
Provider Practice Location
2730 S MOODY AVE
PORTLAND
OR
972015042
Practice Location Phone/Fax
| Phone: | 5034948428 |
| Fax: |
Provider Mailing Location
2730 S MOODY AVE
PORTLAND
OR
972015042
Provider Mailing Phone/Fax
| Phone: | 5034948428 |
| Fax: |