Active NPI
Sophia Kuo, MD
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1720217391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD60471527
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| UNKNOWN | MA | MD | Dermatology Physician |
| MD154163 | OR | MD | Emergency Medicine Physician |
| MD60471527 | WA | MD | Psychiatry Physician |
Interoperability endpoints
- sophia.kuo.1@21578.direct.athenahealth.com
- 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.