Orawan Laochumnanvanit, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20075004NP PMHNP PP Issued in OR

Practice address

3939 NE Hancock St
Suite 301
Portland, OR 97212-5321

Phone

(503) 545-6465

Fax

(503) 287-4940

NPI assigned

May 8, 2007

Sex

Female

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Imani Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1104415405
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1457564817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 NE HANCOCK STREET",
            "address_2": "SUITE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122933",
            "telephone_number": "503-545-6465",
            "fax_number": "503-287-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 NE HANCOCK ST",
            "address_2": "SUITE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125321",
            "telephone_number": "503-545-6465",
            "fax_number": "503-287-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAOCHUMNANVANIT",
        "first_name": "ORAWAN",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30007896",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "20075004NP PMHNP PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9656067",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "olaochumnanvanit501833@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rae Louise Lantsberger, DPM
• Gurion Seth Lantz
• Christie Joyce Rivera Lanuevo, RN, BSN
• Jane Dolson Lanusse, N.N.P.
• Dean Li-Jin Laochamroonvorapongse, M.D.
• Wannasiri Lapcharoensap, M.D.
• Katherine Kelley Lapeter, MA CCC-SLP
• Alexander D Lapidus, M.D.
• Isaac Lapite
• Druanne Laplante, DO

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, 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 Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.