Tristan Nadiene Fujita, ATC-R, OTC

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Practice address

831 NW Council Dr Ste 130
Gresham, OR 97030-3722

Phone

(503) 489-1122

NPI assigned

May 4, 2011

Last updated

Mar 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1114219466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16790 SE DAVIDOFF WAY",
            "city": "DAMASCUS",
            "state": "OR",
            "postal_code": "970895807",
            "telephone_number": "360-204-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR STE 130",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303722",
            "telephone_number": "503-489-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJITA",
        "first_name": "TRISTAN",
        "middle_name": "NADIENE",
        "credential": "ATC-R, OTC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-10139459",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Technologist in Gresham, OR
• Providers in Gresham, OR by specialty
• Surgical Technologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.