NPIMap

Individual provider Active NPI

Warren Ikpomosa Okuns, M.D.

  • Family Medicine Physician
  • Tualatin, OR
National Provider Identifier
1134385461
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD155468 Issued in OR
Practice address
19875 SW 65TH Ave
Suite 100
Tualatin, OR 97062-8353
Phone
(503) 692-7785
Fax
(503) 692-2520
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN12110 FL
Family Medicine Physician 207Q00000X MD155468 OR Primary

Addresses

Primary practice location

19875 SW 65TH Ave
Suite 100
Tualatin, OR 97062-8353

Mailing address

PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111129000298 OR Practitioner - Family Practice 5698949717 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Cynthia Gulick PCGroup PAC ID 2860487279, 23 clinicians
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

11900 SW Greenburg Rd
Tigard, OR 97223-6453
Phone (503) 620-5556

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN12110FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Apr 1, 2012 Accepting new patients
Galen Inpatient Physicians PC CurrentSince May 1, 2016 Accepting new patients
Legacy Clinics LLC CurrentSince Oct 3, 2011 Accepting new patients
Salem Clinic, PC CurrentSince Jun 1, 2024 Accepting new patients
Galen Inpatient Physicians PC CurrentSince May 1, 2016 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Oct 3, 2011 Accepting new patients
Cynthia Gulick, PC Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Legacy Meridian Park Pediatric Rehab Past Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients
My Other Me PastSince Dec 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

11900 SW Greenburg Rd
Tigard, OR 97223
Phone (503) 386-5424

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

19875 SW 65th Ave
Ste 100
Tualatin, OR 97062
Phone (503) 692-7785

1002 N Boones Ferry Rd
Woodburn, OR 97071
Phone (503) 981-9526

Interoperability endpoints

  • Direct secure messaging: wokuns39092@salemclinic.gardenplot.direct-ci.com
  • Direct secure messaging: wokuns34221@direct.lhs.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1134385461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "address_2": "SUITE 100",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785",
            "fax_number": "503-692-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNS",
        "first_name": "WARREN",
        "middle_name": "IKPOMOSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN12110",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD155468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.