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Contact Information

KEN TAKENAKA, ATC, LAT, OTC
11782 SW BARNES RD STE 300
PORTLAND, OR97225-5933
 Phone: 503-214-5200
 Fax: 503-906-6613
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Orthopaedic Assistant

246ZX2200X
Indicates primary specialty

NPI Profile & details for KEN TAKENAKA · (Male)

NPI # 1326204348
Status Active
Credentials ATC, LAT, OTC
Entity Individual
Enumeration date 07/29/2008
Last updated 06/23/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 050802325
  • OR License # AT10145051
  • OR Other ATAT10145051 ATC LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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