Individual provider Active NPI

Aki Nakagawa, MA CCC-SLP

  • Speech-Language Pathologist
  • Portland, OR
National Provider Identifier
1568227114
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012427 Issued in OR
Practice address
5411 SW 34TH PL
Portland, OR 97239-1126
Phone
(503) 490-6805
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 012427 OR Primary

Addresses

Primary practice location

5411 SW 34TH PL
Portland, OR 97239-1126

Mailing address

11855 NE Glenn Widing Dr
Portland, OR 97220-9057
Phone (503) 490-6805

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
012427ORMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1568227114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11855 NE GLENN WIDING DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209057",
            "telephone_number": "503-490-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 SW 34TH PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391126",
            "telephone_number": "503-490-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAGAWA",
        "first_name": "AKI",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "012427",
            "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 Feb 13, 2024; 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.