John Darwin Amundson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3909 South East 70TH Ave.
Portland, OR 97206

Phone

(503) 777-2278

Fax

(503) 774-3852

NPI assigned

Feb 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Johnny Darwin Ahmun Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073651097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3746 SOUTH EAST LAFAYETTE CT.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97206",
            "telephone_number": "502-239-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 SOUTH EAST 70TH AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97206",
            "telephone_number": "503-777-2278",
            "fax_number": "503-774-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "JOHN",
        "middle_name": "DARWIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR",
            "identifier": "171MOOOOOX",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNY",
            "last_name": "AHMUN",
            "middle_name": "DARWIN",
            "prefix": "MR.",
            "credential": "QMHA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wendy K Ampah, BSW
• Maria Ampomah, M.S. CCC-SLP
• Forest Amsden, LAC, MACOM
• Dana Leigh Amunategui, RPH
• Joel A. Amundson, M.D.
• Marquitta Amupitan
• Amy Harris PSYD
• Amy Killen, MD, LLC (BodyLogicMD of Portland)
• Amy Oldendorf
• Amy Robben, LCSW, LLC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.