Basic Information
Provider Information | |||||||||
NPI: | 1295812402 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HASHIMA | ||||||||
FirstName: | JASON | ||||||||
MiddleName: | NAOKI | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D., M.P.H. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 14825 SW BROOKLET PL | ||||||||
Address2: |   | ||||||||
City: | TIGARD | ||||||||
State: | OR | ||||||||
PostalCode: | 972240835 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5035247913 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 9427 SW BARNES RD | ||||||||
Address2: | MOTHER JOSEPH'S PLAZA | ||||||||
City: | PORTLAND | ||||||||
State: | OR | ||||||||
PostalCode: | 972256652 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5038132000 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/01/2006 | ||||||||
LastUpdateDate: | 02/04/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | MD60027534 | WA | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | 390200000X | MD25993 | OR | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 207VX0000X | MD25993 | OR | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
ID | Type | State | Issuer | Description | MD25993 | 01 | OR | UNLIMITED STATE LICENSE | OTHER | MD60027534 | 01 | WA | MEDICAL LICENSE | OTHER |