Provider Demographics
NPI:1760852925
Name:HONDA, TOMOAKI (DNP FNP NP-C ARNP)
Entity type:Individual
Prefix:DR
First Name:TOMOAKI
Middle Name:
Last Name:HONDA
Suffix:
Gender:M
Credentials:DNP FNP NP-C ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 SW MARLOW AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5102
Mailing Address - Country:US
Mailing Address - Phone:503-430-1777
Mailing Address - Fax:
Practice Address - Street 1:1675 SW MARLOW AVE STE 202
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5102
Practice Address - Country:US
Practice Address - Phone:503-430-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 00135235163W00000X
OR099000146RN163W00000X
WAAP60919316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse