Kufa Dekamo

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

201802274LPN Issued in OR

Practice address

3708 SE 144TH Ave
Portland, OR 97236-2731

Phone

(571) 315-7771

NPI assigned

Apr 21, 2018

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524268800000",
    "number": "1629565981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 SE 144TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972362731",
            "telephone_number": "571-315-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 SE 144TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972362731",
            "telephone_number": "571-315-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKAMO",
        "first_name": "KUFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-21",
        "last_updated": "2018-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201802274LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Dejana, D.C.
• Grace Dejarnette, LCSW
• Anthony Douglas Dejesus, SUDPT, CADC-R
• Cambrynne Dejong
• Jessica Anne Dejong, PA-C
• Jennifer Dekany, LMT
• Graham John Dekeyser
• Hakim Dekkiche, DO
• Shea Mertens Deklotz, PA-C
• Jade Del Castillo

• Licensed Practical Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2018; 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.