CREDENA HEALTH LLC (NPI# 1225190408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225190408 |
| Entity Type | Organization |
| Organization Name | CREDENA HEALTH LLC |
| Other Organization Name | CREDENA HEALTH PHARMACY ST VINCENT |
| Practice Address |
9155 Sw Barnes Rd Ste 102 Portland OR 97225-6625 |
| Mailing Address |
Po Box 5936b Portland OR 97228-5936 |
| Practice Telephone | 5032162630 |
| Practice Fax Number | 5032162637 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (ASST CORP SEC FOR ENROLLMENTS) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Credena Health Pharmacy St Vincent | Other Name - Individual/Organization |
| Medical Office Building Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850641 | Credena Health LLC | Pharmacy | 1510 Division St Ste 110, Oregon City, OR 97045-1572 | 2020-08-03 |
| 1629618186 | Credena Health LLC | Durable Medical Equipment & Medical Supplies | 3300 Providence Dr Ste 101, Anchorage, AK 99508-4619 | 2020-01-13 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1396125399 | Credena Health LLC | Pharmacy | 6348 Ne Halsey St, Suite A, Portland, OR 97213-4720 | 2015-06-04 |
| 1164809778 | Credena Health LLC | Pharmacy | 50331a Us Highway 93, Polson, MT 59860-7046 | 2015-05-04 |
| 1124358239 | Credena Health LLC | Pharmacy | 501 S Buena Vista St Fl 1, Burbank, CA 91505 | 2010-01-12 |
| 1568551430 | Credena Health LLC | Pharmacy | 101 W 8th Ave Ste 207653, Spokane, WA 99204 | 2006-10-11 |
| 1235243668 | Credena Health LLC | Pharmacy | 5050 Ne Hoyt St Ste 142, Portland, OR 97213-2956 | 2006-08-19 |
| 1205811601 | Credena Health LLC | Pharmacy | 1140 West La Veta, Orange, CA 92868-3849 | 2005-12-08 |
| 1447249909 | Credena Health LLC | Pharmacy | 19200 N Kelsey Street, Monroe, WA 98272 | 2005-10-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Credena Health LLC | 6348 Ne Halsey St, Suite A, Portland, OR 97213 |
| Iowa Business Entities | CREDENA HEALTH LLC | 6348 Ne Halsey St. Suite A, Portland, OR 97213 |
| Oregon Corporations, Companies and Business Names | CREDENA HEALTH LLC | 6348 Ne Halsey Street, Suite A, Portland, OR 97213 |
| Washington State Corporations | CREDENA HEALTH LLC | 6348 Ne Halsey St, Suite A, Portland, OR 97213-4720 |
| Virginia Business Entities | CREDENA HEALTH LLC | 1801 Lind Ave Sw Ste 9016, Renton, Washington 98057 |
| Street Address |
9155 SW BARNES RD STE 102 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1649800186 | A & S Pharmacy LLC | Pharmacy | 1660 Wildcat Dr, Portland, TX 78374-2830 | 2020-01-23 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1538653654 | Division Pharmacy Inc. | Pharmacy | 10918 Se Division St, Portland, OR 97266-1259 | 2018-06-21 |
| 1659755593 | Portland Professional Pharmacy, LLC | Pharmacy | 11717 Ne Glisan St, Portland, OR 97220-2141 | 2015-07-09 |
| 1992194062 | Professionl Pharmacy | Pharmacy | 10000 Se Main St Ste 201, Portland, OR 97216-2448 | 2015-01-13 |
| 1932597978 | Pharmaca Integrative Pharmacy, Inc | Pharmacy | 240 Nw Lost Springs Terrace, Suite 36, Portland, OR 97229 | 2014-12-29 |
| Find all providers in PORTLAND | ||||
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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.