Ayumi Mizuno, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

10031967 Issued in OR

Practice address

7790 SW Mohawk St
Tualatin, OR 97062-9191

Phone

(503) 885-1515

Fax

(503) 885-1520

NPI assigned

Mar 28, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spinal Diagnostics PCGroup PAC ID 3870588494, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
• Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
• Salem Hospital Hospital, Salem, OR, CCN 380051
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Spinal Diagnostics PC

  • Specialist
  • Tualatin, OR
  • NPI 1194751735
  Medicare reassignment Care Compare group NPD

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

• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620
  Care Compare affiliation
• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Willamette Falls Medical Center

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1215730031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7790 SW MOHAWK ST",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629191",
            "telephone_number": "503-885-1515",
            "fax_number": "503-885-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7790 SW MOHAWK ST",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629191",
            "telephone_number": "503-885-1515",
            "fax_number": "503-885-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUNO",
        "first_name": "AYUMI",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-28",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "10031967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard P Miller, MD
• Molly Phillips Milne, CNM
• Naomi Mimnaugh
• Melissa Miracle, LPC
• Debora Ann Mitchell, APRN, FNP-C
• MK Ortho LLC
• Barbara K Moore, MD
• Victoria Nan Moore, DMD
• Mary E. Morrison, PA-C
• Daniel Moshofsky, PSYD

• Adult Health Nurse Practitioner in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.