Provider Demographics
NPI:1760220792
Name:KARIUKI, ERIC (BSN, RN)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:KARIUKI
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 SW 102ND AVE # A
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3245
Mailing Address - Country:US
Mailing Address - Phone:503-521-7264
Mailing Address - Fax:503-521-7289
Practice Address - Street 1:3815 SW 102ND AVE # A
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3245
Practice Address - Country:US
Practice Address - Phone:503-521-7264
Practice Address - Fax:503-521-7289
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202206983163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse