Individual provider Active NPI

Haruka Swendsen Snow, MD

  • Surgery Physician
  • Oregon City, OR
National Provider Identifier
1891119947
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD201078 Issued in OR
Practice address
1510 Division St Ste 210
Oregon City, OR 97045-1599
Phone
(503) 723-6525
NPI assigned
Feb 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD201078 OR Primary

Addresses

Primary practice location

1510 Division St Ste 210
Oregon City, OR 97045-1599

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

9200 SE 91st Ave
Suite 320
Portland, OR 97086-3756
Phone (503) 353-3005

Other identifiers 1

IdentifierTypeStateIssuer
500689777MedicaidOR

Other names 1

  • Haruka C Swendsen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hsnow527785@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200921001553 OR Practitioner - General Surgery 4688982184 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 1, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 1, 2021 Accepting new patients
Oregon Cosmetic and Reconstructive Clinic, PC PastSince Oct 1, 2020 Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

1510 Division St
Ste 170
Oregon City, OR 97045
Phone (503) 215-6819

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

1510 Division St
Ste 210
Oregon City, OR 97045
Phone (503) 655-6313

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1891119947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 DIVISION ST STE 210",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451599",
            "telephone_number": "503-723-6525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 SE 91st Ave",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "970863756",
            "country_code": "US",
            "telephone_number": "503-353-3005",
            "fax_number": "503-543-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "HARUKA",
        "middle_name": "SWENDSEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD201078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500689777",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsnow527785@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1510 Division St Ste 210",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HARUKA",
            "last_name": "SWENDSEN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.