Susan Ruth Eki, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

200250006NP Issued in OR

Practice address

1217 NE Burnside Rd Ste 503C
Gresham, OR 97030-5770

Phone

(971) 888-2014

Fax

(971) 206-6387

NPI assigned

Jun 4, 2007

Last updated

Sep 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Susan Ruth Sagawa-Eki Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Pediatric Associates of Gresham PC

  • Pediatrics Physician
  • Gresham, OR
  • NPI 1568592913
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1396947065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 SW WALTERS DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970809351",
            "telephone_number": "971-888-2014",
            "fax_number": "971-206-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD STE 503C",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305770",
            "telephone_number": "971-888-2014",
            "fax_number": "971-206-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKI",
        "first_name": "SUSAN",
        "middle_name": "RUTH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "077037817N2",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "077037817N2",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200250006NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSEPRACTITIONER LICENSE",
            "identifier": "077037817N2-PNP-PP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SAGAWA-EKI",
            "middle_name": "RUTH",
            "credential": "PMHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Clem George Eischen Jr., PT
• Kevin Eischen
• Joseph Mark Eisenberg, M.D.
• Bradley Roy Eisenhut, DPT
• Norman Toshiaki Eki, MD
• Elenih Group Home LLC
• Elite Health Care Dba Elite Chiropractic and Wellness Center (Elite Chiropractic and Wellness Center)
• Sarah Elkinton, CCC-SLP
• Emergency and Acute Care Medical Company - Northwest, Inc.
• Emeritus Corporation (Brookdale Chestnut Lane Gresham)

• Psychiatric/Mental Health Nurse Practitioner in Gresham, OR
• Providers in Gresham, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.