Ken Takenaka, ATC, LAT, OTC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT10145051 Issued in OR

Practice address

11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933

Phone

(503) 214-5200

Fax

(503) 906-6613

NPI assigned

Jul 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1326204348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255933",
            "telephone_number": "035-214-5200",
            "fax_number": "503-901-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255933",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKENAKA",
        "first_name": "KEN",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT, OTC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZX2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Orthopedic Assistant",
            "state": "OR",
            "license": "050802325",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT10145051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATC LICENSE",
            "identifier": "ATAT10145051",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Armin B Takallou, MD
• Nancy Takamune, D.C.
• Lina Marie Ahuna Takano, MD
• Valarie Angeline Takayama, MSPT
• Sheri Takemoto-Coppens
• Hiroshi Takeo
• Emi Taketa
• Yumeko Takeuchi, L.AC.
• Victor N Takla, MD
• Julia C. Talajic, MD

• Athletic Trainer in Portland, OR
• Providers in Portland, OR by specialty
• Athletic Trainer in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.