Healthcare Provider Details

I. General information

NPI: 1295994739
Provider Name (Legal Business Name): MARISA LEIKO OISHI MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US 191 AND HOSPITAL ROAD
CHINLE AZ
86503
US

IV. Provider business mailing address

12030 DONNER PASS RD
TRUCKEE CA
96161-0449
US

V. Phone/Fax

Practice location:
  • Phone: 928-674-7090
  • Fax:
Mailing address:
  • Phone: 503-358-5156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA134104
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: