DR. DERRIN YOSHIO KILIPAKI FUKUDA (NPI# 1962781542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962781542 |
| Entity Type | Individual |
| Full Name | DR. DERRIN YOSHIO KILIPAKI FUKUDA |
| Credential | PSY.D. |
| Practice Address |
516 Se Morrison St Ste 400 Portland OR 97214-2344 |
| Practice Telephone | 9712428894 |
| Mailing Telephone | 9712428894 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2016-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
2399 | OR | Behavioral Health & Social Service Providers |
| Street Address |
516 SE MORRISON ST STE 400 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97214-2344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619121670 | Jane Hobart | Psychologist | 516 Se Morrison St Ste 400, Portland, OR 97214-2344 | 2008-11-04 |
| 1689228694 | Joseph Martin Barron | Counselor | 516 Se Morrison St Ste 400, Portland, OR 97214-2344 | 2019-07-29 |
| 1790209955 | Kristen Lauer | Psychologist | 516 Se Morrison St Ste 400, Portland, OR 97214-2344 | 2017-07-31 |
| 1467805309 | Michelle Madalena Tran | Counselor | 516 Se Morrison St Ste 400, Portland, OR 97214-2344 | 2016-07-15 |
| 1679818538 | Erin Lyn Besser | Psychologist | 516 Se Morrison St Ste 400, Portland, OR 97214-2344 | 2012-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1336772243 | Alexandra Mcbryde | Acupuncturist | 959 Se Division St, #315, Portland, OR 97214 | 2020-02-19 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1639616436 | Erin Elizabeth Weaver | Acupuncturist | 1330 Se Cesar E Chavez Blvd. Center for Natural Meidici, Portland, OR 97214 | 2017-01-31 |
| 1780126045 | Katherine Aravamudan, Lpc, LLC | Community/Behavioral Health | 1312 E. Burnside Street, Portland, OR 97214 | 2016-11-17 |
| 1003358441 | Michelle Jean Meadows | Massage Therapist | 2804 Se Lincoln St, Portland, OR 97214 | 2016-11-16 |
| 1629429311 | Stephanie Tolentino | Counselor | 605 Se Cesar E Chavez Blvd., Portland, OR 97214 | 2016-06-24 |
| 1790141166 | Marian Iris Dixon | Massage Therapist | 3810 Se Belmont St., Earthbody Wellness Center East, Portland, OR 97214 | 2016-01-14 |
| 1194194589 | Lutheran Community Services Northwest | Community/Behavioral Health | 605 Se Cesar E Chavez Bld, Portland, OR 97214 | 2015-09-16 |
| 1497123566 | Michele R. Stokes | Specialist | 2311 East Burnside B1, Portland, OR 97214 | 2015-09-08 |
| Find all providers in zip 97214 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912530643 | Positive Development for Youth and Families, Inc. | Psychologist | 4531 Se Belmont St Ste 110, Portland, OR 97215-1675 | 2020-02-21 |
| 1902440704 | Alicia Hoffman | Psychologist | 1577 Congress St Ste 2, Portland, ME 04102-2169 | 2019-11-05 |
| 1467819631 | Megan Nichols | Psychologist | 2734 Se 29th Ave, Apt B, Portland, OR 97202-1381 | 2016-01-19 |
| 1891043360 | Margaret Arnold Stoeckel | Psychologist | 5041 Se Taylor St, Portland, OR 97215-2624 | 2012-08-15 |
| 1851532139 | Charlene Eickholt | Psychologist | 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497 | 2009-03-16 |
| 1215081716 | Holly Linn Crossen | Psychologist | 1130 Sw Morrison St Ste 618, Portland, OR 97205-2217 | 2007-01-22 |
| 1972654697 | Nicholas John Ure | Psychologist | 101 Se 12th Ave, Portland, OR 97214-1319 | 2007-01-16 |
| 1528134772 | Marianne Michelle Kabour | Psychologist | 2801 N Gantenbein Ave Fl 3, Portland, OR 97227-1623 | 2006-11-28 |
| 1578588539 | Shirley May Hanson | Psychologist | 7912 Sw 35th Ave, Suite 6, Portland, OR 97219-2427 | 2006-07-12 |
| 1518904457 | Redmond Andrew Reams | Psychologist | 2106 Ne 40th Ave, Portland, OR 97212-5405 | 2006-05-31 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.