Active NPI
Takehiko Yamamoto
- Occupational Therapist
- Milwaukie, OR
National Provider Identifier
1225525140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12412
- Practice address
- 4560 SE International Way Ste 100
Milwaukie, OR 97222-4628 - Phone
- (909) 793-1233
- NPI assigned
- Apr 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12412 | CA | Primary |
Addresses
Primary practice location
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Mailing address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225X00000X | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12412 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523836800000",
"number": "1225525140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972224628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972224628",
"telephone_number": "909-793-1233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMAMOTO",
"first_name": "TAKEHIKO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-16",
"last_updated": "2018-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "12412",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "225X00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.