Individual provider Active NPI

Sophia Kuo, MD

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1720217391
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD60471527 Issued in WA
Practice address
3115 NE 47TH Ave
Portland, OR 97213-1822
Phone
(206) 741-4737
Fax
(833) 645-0023
NPI assigned
Jul 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD163702 OR
Psychiatry Physician 2084P0800X UNKNOWN MA
Psychiatry Physician 2084P0800X MD154163 OR
Child & Adolescent Psychiatry Physician 2084P0804X MD154163 OR
Psychiatry Physician 2084P0800X MD60471527 WA Primary

Addresses

Primary practice location

3115 NE 47TH Ave
Portland, OR 97213-1822

Mailing address

1037 NE 65TH St # 87777
Seattle, WA 98115-6655
Phone (206) 741-4737

Other practice location 1

1616 Cornwall Ave
Bellingham, WA 98225-4648
Phone (360) 676-6177

Other practice location 2

3036 NE Martin Luther King Jr Blvd
Portland, OR 97212-3053
Phone (503) 283-3763

Other practice location 3

847 NE 19th Ave Ste 100
Portland, OR 97232
Phone (503) 238-0769

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
UNKNOWNMAMDDermatology Physician
MD154163ORMDEmergency Medicine Physician
MD60471527WAMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: sophia.kuo.1@21578.direct.athenahealth.com
  • Direct secure messaging: sophia.kuo.2@21578.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1246752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1720217391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 NE 65TH ST # 87777",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156655",
            "telephone_number": "206-741-4737",
            "fax_number": "833-645-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 NE 47TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131822",
            "telephone_number": "206-741-4737",
            "fax_number": "833-645-0023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 Cornwall Ave",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982254648",
            "country_code": "US",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3036 NE Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972123053",
            "country_code": "US",
            "telephone_number": "503-283-3763",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "847 NE 19th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97232",
            "country_code": "US",
            "telephone_number": "503-238-0769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUO",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-05",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD163702",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "UNKNOWN",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD154163",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD154163",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60471527",
            "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 May 21, 2021; 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.