PROVIDENCE HEALTH & SERVICE - OREGON (NPI# 1386034312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386034312 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICE - OREGON |
| Other Organization Name | PROVIDENCE PORTLAND MEDICAL CENTER PHARMACY |
| Practice Address |
4805 Ne Glisan St Portland OR 97213-2933 |
| Practice Telephone | 5032156080 |
| Mailing Telephone | 5032156080 |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |
| Authorized Official Name | TAVIS SMITH (OPERATIONS MANAGER) |
| Authorized Official Telephone | 5032156296 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP-0000780 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2149074 | 01 |
| Other Name | Type Code |
|---|---|
| Providence Portland Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457625501 | Providence Health & Service - Oregon | Clinic/Center | 5050 Ne Hoyt St, Suite 511, Portland, OR 97213-2984 | 2012-03-06 |
| Street Address |
4805 NE GLISAN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337572 | John F Zurasky | Psychiatry & Neurology | 4805 Ne Glisan St, Ste 3g37, Portland, OR 97213-2933 | 2005-06-22 |
| 1083228175 | Alysia M Paaluhi | Registered Nurse | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2020-09-04 |
| 1619595964 | Kathleen Hahn | Dietitian, Registered | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2020-07-13 |
| 1841839107 | Daniel Dean Rosema | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2020-01-03 |
| 1588207666 | Jean Hannon Mullins-padgett | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-10-22 |
| 1043853146 | Miranda Meyer | Dietitian, Registered | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-10-21 |
| 1083260830 | Becky L Bowler | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-08-16 |
| 1366096406 | Nicole W Engel | Registered Nurse | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-07-26 |
| 1558924753 | Susan Lien | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-04-15 |
| 1356809644 | Katheryne Zempel | Physical Therapist | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| 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.