SUSAN RUTH SAGAWA (NPI# 1396947065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396947065 |
| Entity Type | Individual |
| Full Name | SUSAN RUTH SAGAWA |
| Other Name | SUSAN RUTH SAGAWA-EKI |
| Credential | MHPNP |
| Practice Address |
2150 Ne Division St Ste 103 Gresham OR 97030-5813 |
| Practice Telephone | 5036614200 |
| Practice Fax Number | 5036660566 |
| Mailing Telephone | 5036614200 |
| Mailing Fax Number | 5036660566 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
077037817N2 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NURSEPRACTITIONER LICENSE | 077037817N2-PNP-PP | 01 |
| Street Address |
2150 NE DIVISION ST STE 103 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-5813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548259252 | John H Frick Dmd PC | Dentist | 2150 Ne Division St, #210, Gresham, OR 97030-5813 | 2005-10-14 |
| 1760636005 | Gresham Optical, Inc | Eyewear Supplier (Equipment, not the service) | 2150 Ne Division St, Suite 101, Gresham, OR 97030-5813 | 2008-11-13 |
| 1285887786 | Gabriela Aranda | Dentist | 2150 Ne Division St, Suite 203, Gresham, OR 97030-5813 | 2008-10-28 |
| 1164632048 | Janie Donalda Griffin | Nurse Practitioner | 2150 Ne Division St, Ste 103, Gresham, OR 97030-5813 | 2007-05-22 |
| 1831309830 | Amy Marie Young | Nurse Practitioner | 2150 Ne Division St, Ste 103, Gresham, OR 97030-5813 | 2007-05-22 |
| 1417008517 | June Kwan Wu | Pediatrics | 2150 Ne Division St, Suite 103, Gresham, OR 97030-5813 | 2007-01-15 |
| 1598816605 | Gregory David Emmerich | Pediatrics | 2150 Ne Division St, Suite103, Gresham, OR 97030-5813 | 2007-01-15 |
| 1699733758 | Greg Brophy | Optometrist | 2150 Ne Division St, Suite 101, Gresham, OR 97030-5813 | 2006-05-01 |
| 1871569020 | B. Edward Yanke | Obstetrics & Gynecology | 2150 Ne Division St, Ste 202, Gresham, OR 97030-5813 | 2006-02-27 |
| 1457323495 | Catherine B Saul | Optometrist | 2150 Ne Division St, Suite 101, Gresham, OR 97030-5813 | 2006-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164079588 | Patrick Lohse | Nurse Practitioner | 955 Ne 3rd St, Gresham, OR 97030-7418 | 2019-08-20 |
| 1568661528 | Stacy L. Hartline | Nurse Practitioner | 912 Ne Kelly Ave, Suite 200, Gresham, OR 97030 | 2007-07-11 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1447336037 | Kerry E M Phifer | Nurse Practitioner | 1700 Nw Civic Dr, Suite 301, Gresham, OR 97030-3770 | 2006-10-27 |
| 1215587126 | Healingspaces4u | Nurse Practitioner | 2951 Nw Division St Ste 120, Gresham, OR 97030-5293 | 2019-09-13 |
| 1487191797 | Lifespan Psychiatric Consulting, LLC | Nurse Practitioner | 320 N Main Ave, Suite 209, Gresham, OR 97030-7242 | 2017-01-24 |
| 1366812372 | Tyler Clark Chipman | Nurse Practitioner | 600 Ne 8th St Ste 300, Gresham, OR 97030-7318 | 2015-10-02 |
| 1790806149 | Daniel Ken Kamada | Nurse Practitioner | 333 Se 223rd Ave, Ste 204, Gresham, OR 97030-7454 | 2007-04-03 |
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| 1366071607 | Med Rx Partners, P.C. | Nurse Practitioner | 12115 Sw 70th Ave Ste 202, Tigard, OR 97223-9648 | 2020-04-08 |
| 1417583170 | Brittany Joy Monson | Nurse Practitioner | 12115 Sw 70th Ave, Tigard, OR 97223-9647 | 2020-03-13 |
| 1073147716 | Paradigm Mental Health and Wellness LLC | Nurse Practitioner | 724 S Central Ave Ste 101d, Medford, OR 97501-7808 | 2020-03-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.