Individual provider Active NPI

Calvin Tanabe, M.D.

  • Neurological Surgery Physician
  • Portland, OR
National Provider Identifier
1407902760
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD6702 Issued in OR
Practice address
9155 SW Barnes Rd
Ste 440
Portland, OR 97225-6625
Phone
(503) 297-3766
Fax
(503) 297-8128
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD6702 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd
Ste 440
Portland, OR 97225-6625

Mailing address

9155 SW Barnes Rd
Ste 440
Portland, OR 97225-6625
Phone (503) 297-3766

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD6702ORMDNeurological Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407902760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "STE 440",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-297-3766",
            "fax_number": "503-297-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "STE 440",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-297-3766",
            "fax_number": "503-297-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANABE",
        "first_name": "CALVIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD6702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.