Anita Tam Su, MD

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

MD19238 Issued in OR

Practice address

545 NE 47TH Ave
Ste. 310
Portland, OR 97213-2238

Phone

(503) 238-6233

Fax

(503) 231-7668

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Anita Su Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Asthma and Allergy Clinic, LLC

  • Allergy & Immunology Physician
  • Portland, OR
  • NPI 1407156482
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891905261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 NE 47TH AVE",
            "address_2": "STE. 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132238",
            "telephone_number": "503-636-1310",
            "fax_number": "503-636-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 NE 47TH AVE",
            "address_2": "STE. 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132238",
            "telephone_number": "503-238-6233",
            "fax_number": "503-231-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM SU",
        "first_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "OR",
            "license": "MD19238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "SU",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nora Jean Tallman, CNM
• Lauren Scott Talman, MD
• Sally Talmi
• Alana Lei Talob, LCSW
• Isaiah Talton
• Allen Wai-Hung Tam, D.M.D.
• Christine Tam
• Claire Tam, LPC
• Lori Tam
• Marcel Michael Tam, MD, MBA

• Allergy Physician in Portland, OR
• Providers in Portland, OR by specialty
• Allergy Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.