Individual provider Active NPI

Manami Furuya, NP

  • Family Nurse Practitioner
  • Lake Oswego, OR
National Provider Identifier
1396935870
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200850101NP FNP-PP Issued in OR
Practice address
5 Centerpointe Dr
Suite 600
Lake Oswego, OR 97035-8651
Phone
(503) 444-0556
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 200040575RN OR
Registered Nurse 163W00000X RN60180981 WA
Nurse Practitioner 363L00000X AP60180982 WA
Family Nurse Practitioner 363LF0000X 200850101NP FNP-PP OR Primary

Addresses

Primary practice location

5 Centerpointe Dr
Suite 600
Lake Oswego, OR 97035-8651

Mailing address

5439 NW Skycrest Pkwy
Portland, OR 97229-2306
Phone (503) 310-7535

Other practice location 1

2150 N 107th St Ste 480
Seattle, WA 98133-9009
Phone (209) 962-3535

Other identifiers 1

IdentifierTypeStateIssuer
R181408OtherPTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090102000416 OR Practitioner - Nurse Practitioner 5890857635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200850101NP FNP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agewell Geriatrics, LLC CurrentSince Nov 8, 2022 Accepting new patients

Locations

8630 SW Scholls Ferry Rd
Beaverton, OR 97008
Phone (971) 533-0311

Interoperability endpoints

  • Direct secure messaging: mfuruya423740@direct.peacehealth.org
  • Direct secure messaging: mfuruya714866@direct.ochin.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396935870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 NW SKYCREST PKWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292306",
            "telephone_number": "503-310-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR",
            "address_2": "SUITE 600",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358651",
            "telephone_number": "503-444-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 N 107th St Ste 480",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981339009",
            "country_code": "US",
            "telephone_number": "209-962-3535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FURUYA",
        "first_name": "MANAMI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200040575RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60180981",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60180982",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200850101NP FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R181408",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.