MOHAMMAD REZA SASAN (NPI# 1164850723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164850723 |
| Entity Type | Individual |
| Full Name | MOHAMMAD REZA SASAN |
| Credential | RPH |
| Practice Address |
19200 Sw Martinazzi Ave Tualatin OR 97062-6357 |
| Practice Telephone | 5036914233 |
| Practice Fax Number | 5036914220 |
| Mailing Telephone | 5036914233 |
| Mailing Fax Number | 5036914220 |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2017-05-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 35947 | TX | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 13388 | OR | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
0013388 | OR | Pharmacy Service Providers |
| Street Address |
19200 SW MARTINAZZI AVE |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-6357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225076276 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2006-06-03 |
| 1245717792 | Chris Omar Jamus | Optometrist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2018-07-26 |
| 1336673466 | Ghada Shaya | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2017-04-14 |
| 1033652250 | Sari Jouihan | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2016-11-19 |
| 1053716159 | Michael Lu | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2014-10-31 |
| 1396187308 | Lisa East Mai | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2013-07-19 |
| 1295072916 | Amber Lee Judge | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2013-01-15 |
| 1073865333 | Nicholas Chang | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2012-10-11 |
| 1023370939 | Annie Ya-yen Liang | Optometrist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2012-06-15 |
| 1649544883 | Wassim Ayoub | Pharmacist | 19200 Sw Martinazzi Ave, Tualatin, OR 97062-6357 | 2012-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144737677 | Matthew Ito | Pharmacist | 5805 Sw Delker Rd, Tualatin, OR 97062-7753 | 2018-01-05 |
| 1689217044 | Jacob White | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2019-10-17 |
| 1396284840 | Shawn Kwon-chang | Pharmacist | 19185 Sw 90th Ave, Tualatin, OR 97062-7558 | 2017-02-16 |
| 1962945329 | Rick Baldwin | Pharmacist | 19185 Sw 90th Ave, Tualatin, OR 97062-7558 | 2016-12-02 |
| 1003361072 | Pam K Cockrell | Pharmacist | 19185 Sw 90th Ave, Tualatin, OR 97062-7558 | 2016-08-19 |
| 1801257324 | Ryan Wargo | Pharmacist | 19875 Sw 65th Ave, Suite 100, Tualatin, OR 97062-8353 | 2016-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194385674 | Joseph Lee Combee | Pharmacist | 4956 Sw Aster St, Corvallis, OR 97333-1367 | 2019-06-17 |
| 1538627377 | Jacquelyn Jessica Lansing | Pharmacist | 33190 Bloomberg Rd, Eugene, OR 97405-9609 | 2019-03-12 |
| 1972097699 | Nathan Daniel Hoover | Pharmacist | 1401 North 10th Ave, Stayton, OR 97383 | 2018-06-16 |
| 1083119994 | Timothy Warren Evans | Pharmacist | 2714 Harbeck Rd, Grants Pass, OR 97527-5630 | 2018-03-24 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1336662204 | Jenny French | Pharmacist | 9427 Sw Barnes Rd Ste 295, Portland, OR 97225-6652 | 2017-07-21 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1841747649 | Richard Bennett | Pharmacist | 425 Burlwood Ave N, Monmouth, OR 97361-2252 | 2016-09-09 |
| 1316390008 | Timothy L Lichlyter | Pharmacist | 2924 Siskiyou Blvd Ste 102, Medford, OR 97504-8194 | 2016-07-18 |
| 1245695956 | M. Katherine Welch | Pharmacist | 3228 Sw Water Ave, Portland, OR 97239-4632 | 2015-12-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.