Provider Demographics
NPI:1952797508
Name:AIKAWA, YUMI (DO)
Entity Type:Individual
Prefix:
First Name:YUMI
Middle Name:
Last Name:AIKAWA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 MARCOLA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-2594
Mailing Address - Country:US
Mailing Address - Phone:541-747-4300
Mailing Address - Fax:541-747-0655
Practice Address - Street 1:1800 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4379
Practice Address - Country:US
Practice Address - Phone:541-747-4300
Practice Address - Fax:541-746-0655
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00882207Q00000X
ORDO189235208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500753182Medicaid