KOJI KAINUMA (NPI# 1669898268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669898268 |
| Entity Type | Individual |
| Full Name | KOJI KAINUMA |
| Practice Address |
255 Lancaster Dr Ne Salem OR 97301-5155 |
| Practice Telephone | 5035768400 |
| Practice Fax Number | 5033640775 |
| Mailing Telephone | 5035768400 |
| Mailing Fax Number | 5033640775 |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2020-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201904695RN | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201905019NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95001713 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 255 Lancaster Dr Ne, Salem, OR 973015155 | 5035768400 | 5033640775 |
| Street Address |
255 LANCASTER DR NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-5155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255322269 | Heather Diaz | Family Medicine | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2005-10-31 |
| 1790335016 | Madel Carmen Meza Cortes | Case Manager/Care Coordinator | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2019-09-18 |
| 1477107092 | Erika Marcia Rosin | Registered Nurse | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2019-07-31 |
| 1205303922 | Martha Laura Martinez | Case Manager/Care Coordinator | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2018-10-31 |
| 1073088191 | Fiorella Saavedra | Physician Assistant | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2018-10-04 |
| 1053808253 | Laboratory Corporation of America | Clinical Medical Laboratory | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2018-04-13 |
| 1780188300 | Oyindamola Osibanjo | Pharmacist | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2018-03-20 |
| 1588179113 | Stephanie Elaine Burnham | Registered Nurse | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2017-12-05 |
| 1013446640 | Emily Gray | Pharmacist | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2017-06-07 |
| 1285169318 | Thien-y Maria Hoang | Dentist | 255 Lancaster Dr Ne, Salem, OR 97301 | 2017-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| 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 |
|---|---|---|---|---|
| 1366073421 | Aspire Telepsychiatry | Nurse Practitioner | 1910 24th St Ne, Salem, OR 97301-8150 | 2020-01-28 |
| 1962058362 | Kimberly Diane Nelson | Nurse Practitioner | 35 Congress St Ste 225, Salem, MA 01970-5529 | 2019-08-13 |
| 1861970972 | Norrine Mcnelley | Nurse Practitioner | 25 Beechwood Rd, Salem, NH 03079 | 2018-07-31 |
| 1235493495 | Sarah Frances Robbins | Nurse Practitioner | 1595 Roosevelt St Ne, Salem, OR 97301 | 2012-07-02 |
| 1700155538 | Vanessa Anne Underwood | Nurse Practitioner | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2011-12-22 |
| 1134364524 | Sharon Vaden Karn | Nurse Practitioner | 870 Commercial St Se, Salem, OR 97302-4108 | 2008-12-12 |
| 1861605768 | Barbara S Miller | Nurse Practitioner | Odoc, 2605 State St, Salem, OR 97310-0001 | 2007-05-07 |
| 1538225818 | Aleyna Cecile Reed | Nurse Practitioner | 685 Cottage St Ne, Salem, OR 97301-2419 | 2006-12-29 |
| 1407915408 | James Ben Newman | Nurse Practitioner | 1235 Woodrow St Ne, Salem, OR 97303-3214 | 2006-12-06 |
| 1033285713 | Rita Herlong | Nurse Practitioner | 4035 12th Street Cutoff, Suit120, Salem, OR 97302-1764 | 2006-11-27 |
| Find all providers in SALEM | ||||
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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.