Provider Demographics
NPI:1427147008
Name:TRUMAN M. SASAKI, MD, PC
Entity type:Organization
Organization Name:TRUMAN M. SASAKI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUMAN
Authorized Official - Middle Name:MAKOTO
Authorized Official - Last Name:SASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-338-5353
Mailing Address - Street 1:PO BOX 23200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97281-3200
Mailing Address - Country:US
Mailing Address - Phone:503-338-5353
Mailing Address - Fax:503-338-5252
Practice Address - Street 1:2055 EXCHANGE ST
Practice Address - Street 2:SUITE 290
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3419
Practice Address - Country:US
Practice Address - Phone:503-338-5353
Practice Address - Fax:503-338-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD09424208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR856096000OtherREGENCE BC/BS
OR246397Medicaid
ORDD7060OtherRAILROAD MEDICARE
ORL3053 01OtherPACIFICSOURCE HEALTH PLAN
WA1121193Medicaid
WA0188115OtherDEPT LABOR & INDUSTRIES
WA0188115OtherDEPT LABOR & INDUSTRIES
WA1121193Medicaid