JEFFREY A CLARK (NPI# 1356461750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356461750 |
| Entity Type | Individual |
| Full Name | JEFFREY A CLARK |
| Credential | RPH |
| Practice Address |
600 Nw 10th Ave Portland OR 97209-3202 |
| Mailing Address |
16170 Se Goosehollow Dr Damascus OR 97015-7885 |
| Practice Telephone | 5032274835 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH0010544 | OR | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505914 | Jeffrey Scott Clark | Counselor | 402 E Yakima Ave Ste 800-c, Yakima, WA 98901-5407 | 2020-03-31 |
| 1063805844 | Jeffrey Clark | Specialist/Technologist | 315 Reber Ave, Lancaster, OH 43130-1761 | 2015-03-18 |
| 1134535248 | Jeffrey Clark | Hearing Instrument Specialist | 123 E Mondamin St, Minooka, IL 60447-9896 | 2014-07-09 |
| 1174942353 | Jeffrey Clark | Pediatrics | 9576 Hwy 70, Department of Pediatrics, Minocqua, WI 54548 | 2014-04-15 |
| 1881958767 | Jeffrey Kenneth Clark | Pharmacist | 12850 E Montview Blvd Ste C238, Aurora, CO 80045-2605 | 2012-06-26 |
| 1912285495 | Jeffrey S Clark | Chiropractor | 203 Railroad St Ste 3c, Buda, TX 78610-3437 | 2011-08-01 |
| 1003100934 | Jeffrey Paul Clark | Dentist | 1403 N Loop 336 W, Conroe, TX 77304-3503 | 2011-06-08 |
| 1942520044 | Jeffrey B Clark | Dentist | 2133 Belcourt Avenue, Nashville, TN 37212-3503 | 2010-06-11 |
| 1730405333 | Jeffrey Clark | Pharmacist | 611 N Perry St, Bldg #2, Suite 202, Spokane, WA 99202-5011 | 2010-04-08 |
| 1891989158 | Jeffrey Michael Clark | Dentist | 10429 Lagrima De Oro Rd Ne, Albuquerque, NM 87111 | 2007-08-30 |
| Street Address |
600 NW 10TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154872711 | Amanda Hurley | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2016-10-19 |
| 1568865145 | Cassandra Petraitis | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2014-09-26 |
| 1740613587 | Tinamarie Pontes | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2013-08-15 |
| 1033460969 | Jared Robert Gallegos | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2012-10-02 |
| 1417264375 | Stephanie Beth Taylor | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2010-09-13 |
| 1255599387 | Aurora Maureen Preston | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2008-05-27 |
| 1124216445 | Bobbi Erin Doughton | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2007-10-11 |
| 1992997829 | Paulette Kay Egging | Pharmacist | 600 Nw 10th Ave, Portland, OR 97209-3202 | 2007-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460371 | Samantha Nozomi Murata | Pharmacist | 5415 Sw Beaverton Ct Hwy, Portland, OR 97221 | 2020-09-08 |
| 1053923920 | Hoang Lan Ngoc Doan | Pharmacist | 4201 Ne 129th Pl, Portland, OR 97230-1405 | 2020-08-20 |
| 1528677531 | Mi Pham | Pharmacist | 5824 Se 134th Pl, Portland, OR 97236-2987 | 2020-07-26 |
| 1700407350 | Emad Banoub | Pharmacist | 1105 Hyw 181, Portland, TX 78374 | 2020-05-05 |
| 1255951471 | Nam Lai | Pharmacist | 2655 Se 50th Ave Apt 415, Portland, OR 97206-1577 | 2020-04-17 |
| 1275167439 | Mayasah Anas Sedeeq Al Bazzaz | Pharmacist | 15122 Nw Fig Ln, Portland, OR 97229-6986 | 2020-02-26 |
| 1427696632 | Thai Tran | Pharmacist | 7901 Se Powell Blvd, Portland, OR 97206-2314 | 2019-12-18 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1952966970 | Linda P. Pham | Pharmacist | 7901 Se Powell Blvd Ste K, Portland, OR 97206-2314 | 2019-05-06 |
| 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.