FRED MEYER STORES INC (NPI# 1225074768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225074768 |
| Entity Type | Organization |
| Organization Name | FRED MEYER STORES INC |
| Other Organization Name | FRED MEYER PHARMACY |
| Practice Address |
16301 Se 82nd Dr Clackamas OR 97015-9598 |
| Mailing Address |
P.o. Box 842772 Boston MA 02284 |
| Practice Telephone | 5036573064 |
| Practice Fax Number | 5036571580 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621019 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP0000735CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2077781 | 01 | |
| OR | 043224 | 05 |
| Other Name | Type Code |
|---|---|
| FRED MEYER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942746672 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 5502 Point Fosdick Dr Nw, Gig Harbor, WA 98335-1725 | 2017-01-19 |
| 1154695849 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 26520 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8394 | 2012-02-28 |
| 1053580548 | Fred Meyer Stores Inc | Pharmacy | 2801 Bickford Ave, Snohomish, WA 98290-1734 | 2008-02-28 |
| 1497976930 | Fred Meyer Stores Inc | Pharmacy | 500 Mercer St, Seattle, WA 98109-4654 | 2007-05-01 |
| 1740401272 | Fred Meyer Stores Inc | Pharmacy | 17411 Se 272nd St, Covington, WA 98042-5311 | 2007-05-01 |
| 1689730046 | Fred Meyer Stores Inc | Pharmacy | 1600 W Dravus St, Seattle, WA 98119-1721 | 2006-12-29 |
| 1295809598 | Fred Meyer Stores Inc | Pharmacy | 23475 Ne Novelty Hill Rd, Redmond, WA 98053-5501 | 2006-11-20 |
| 1730253261 | Fred Meyer Stores Inc | Pharmacy | 27008 92nd Ave Nw, Stanwood, WA 98292-5343 | 2006-11-17 |
| 1194899625 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 9999 Holman Rd Nw, Seattle, WA 98117-2041 | 2006-11-17 |
| 1912071440 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 700 Sleater Kinney Rd Ne, Lacey, WA 98503 | 2006-11-17 |
| Street Address |
16301 SE 82ND DR |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-9598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790021574 | Tresa Marie Mokalla | Pharmacist | 16301 Se 82nd Dr, Clackamas, OR 97015-9598 | 2012-12-23 |
| 1417220450 | Robert Harold Hagen | Pharmacist | 16301 Se 82nd Dr, Clackamas, OR 97015-9598 | 2012-02-22 |
| 1508139585 | Quang Huu Nguyen | Pharmacist | 16301 Se 82nd Dr, Clackamas, OR 97015-9598 | 2012-02-21 |
| 1063785160 | Brenda K Gibson | Pharmacist | 16301 Se 82nd Dr, Clackamas, OR 97015-9598 | 2012-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538612973 | Akshar Pharmacy LLC | Pharmacy | 9124 Se Saint Helens St, Clackamas, OR 97015-9780 | 2016-08-02 |
| 1114312451 | Willamette Pain & Spine Center PC | Pharmacy | 10001 Se Sunnyside Rd Ste 100a, Clackamas, OR 97015-9728 | 2015-04-03 |
| 1023128659 | Costco Wholesale Corporation | Pharmacy | 13130 Se 84th Ave, Clackamas, OR 97015-9733 | 2006-08-30 |
| 1124495809 | Safeway Pharmacy | Pharmacy | 16300 Se Evelyn St, Clackamas, OR 97015-9515 | 2015-08-28 |
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| 1346850641 | Credena Health LLC | Pharmacy | 1510 Division St Ste 110, Oregon City, OR 97045-1572 | 2020-08-03 |
| 1235747775 | Cordant Pharmacy Oregon, LLC | Pharmacy | 6135 Ne 80th Ave Ste A2, Portland, OR 97218-4033 | 2020-07-21 |
| 1578184909 | Capsule Portland LLC | Pharmacy | 416 Nw 12th Ave, Portland, OR 97209-2907 | 2020-04-27 |
| 1588291645 | Avita Drugs Oregon, LLC | Pharmacy | 2236 Se Belmont St Ste B, Portland, OR 97214-2817 | 2020-03-26 |
| 1467090183 | Mosaic Medical | Pharmacy | 375 Nw Beaver St Ste 103, Prineville, OR 97754-1802 | 2019-12-12 |
| 1598302119 | Beacon Health Care Solutions Incorporated | Pharmacy | 2790 Broadway Ave, North Bend, OR 97459-2216 | 2019-12-02 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 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.