Kanapathy - Suppaiah, RN, PMHNP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

079043086N6 Issued in OR

Practice address

2301 NW Thurman St Ste a
Portland, OR 97210-2581

Phone

(503) 243-7907

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497971014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 NW THURMAN ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102581",
            "telephone_number": "503-243-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 NW THURMAN ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102581",
            "telephone_number": "503-243-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPAIAH",
        "first_name": "KANAPATHY",
        "middle_name": "-",
        "name_prefix": "Mr.",
        "credential": "RN, PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "079043086N6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyung Sunwoo, DMD
• Andrew F Sunwood, DO
• Elizabeth Rachel Super, MD
• Superb Physical Therapy and Wellness LLC
• Lenore Supnet, D.M.D.
• Ryne Supplitt
• Raveena Supra
• Kellie Supriano, M.S.
• Ria Sur
• Anne Marie Suran, LMT, LMP, NCTMB

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• 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.