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General NPI Number Information
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NPI Number | 1578106217
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Entity Type | Individual
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Provider Name | SIMONPETER O EMOKPAIRE NP
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Gender | Male
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 3000 MARKET ST NE STE 510
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City | SALEM
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State | OR
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Zip | 97301-1807
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Country | US
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Telephone | 971-439-0234
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Fax | 832-321-2981
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Provider Business Mailing Address
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Address Line | 3000 MARKET ST NE STE 510
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City | SALEM
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State | OR
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Zip | 97301-1807
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Country | US
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Telephone | 971-439-0234
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Fax | 832-321-2981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 35266
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP144841
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202209114RN
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 840583
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202209315NP-PP
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License Number State | OR
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