Individual provider Active NPI

Mami Yamada

  • Peer Specialist
  • Hillsboro, OR
National Provider Identifier
1467130310
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
108560 Issued in OR
Practice address
5240 NE Elam Young Pkwy Ste 100
Hillsboro, OR 97124-6438
Phone
(503) 846-3350
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 108560 OR Primary

Addresses

Primary practice location

5240 NE Elam Young Pkwy Ste 100
Hillsboro, OR 97124-6438

Mailing address

5240 NE Elam Young Pkwy Ste 100
Hillsboro, OR 97124-6438
Phone (503) 846-3350

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

State licenses

LicenseStateTypeSpecialty
108560ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1467130310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 NE ELAM YOUNG PKWY STE 100",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246438",
            "telephone_number": "503-846-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 NE ELAM YOUNG PKWY STE 100",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246438",
            "telephone_number": "503-846-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "MAMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "108560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.