Individual provider Active NPI

Michelle Ann Lu

  • Homemaker
  • Portland, OR
National Provider Identifier
1699190751
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
NAR.NA.60451427 Issued in WA
Practice address
11124 NE Halsey St # 572
Portland, OR 97220-2021
Phone
(888) 354-2758
NPI assigned
Feb 26, 2014
Last updated
Feb 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X NAR.NA.60451427 WA Primary

Addresses

Primary practice location

11124 NE Halsey St # 572
Portland, OR 97220-2021

Mailing address

11124 NE Halsey St # 572
Portland, OR 97220-2021

Other names 1

  • Michelle Ann Suazo Gamulo Former name

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
NAR.NA.60451427WAMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1699190751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 NE HALSEY ST # 572",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 NE HALSEY ST # 572",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202021",
            "telephone_number": "888-354-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "MICHELLE ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "WA",
            "license": "NAR.NA.60451427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE ANN",
            "last_name": "GAMULO",
            "middle_name": "SUAZO",
            "credential": "NAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 26, 2014; 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.