Active NPI
Paul Edward Okamoto, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1962486373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 272594
- Practice address
- 1730 NE 10TH Ave
Portland, OR 97212-4038 - Phone
- (503) 224-2225
- Fax
- (503) 222-3883
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 272594 | OR | Primary |
Addresses
Primary practice location
1730 NE 10TH Ave
Portland, OR 97212-4038
Mailing address
1730 NE 10TH Ave
Portland, OR 97212-4038
Phone (503) 224-2225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100121000142 | OR | Practitioner - Chiropractic | 7315836558 | Practice locations: Portland, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 272594 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287446400000",
"number": "1962486373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1730 NE 10TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972124038",
"telephone_number": "503-224-2225",
"fax_number": "503-222-3883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1730 NE 10TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972124038",
"telephone_number": "503-224-2225",
"fax_number": "503-222-3883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKAMOTO",
"first_name": "PAUL",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2010-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "272594",
"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 Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.