TANISHA PECK


Address: 1700 E 19th St, The Dalles, OR 97058-3317
Phone: 5412691111

TANISHA PECK (NPI# 1396121265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396121265
Entity Type Individual
Full Name TANISHA PECK
Credential PHARM. D.
Practice Address 1700 E 19th St
The Dalles
OR 97058-3317
Mailing Address 1775 Thompson Rd
Coos Bay
OR 97420-2125
Practice Telephone 5412691111
Mailing Telephone 5412694176
Mailing Fax Number 5412698329
Enumeration Date 2015-08-03
Last Update Date 2019-12-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 183500000X Pharmacist 5294005-8911 UT Pharmacy Service Providers
Y 1835P0018X Pharmacist
Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0013207 OR Pharmacy Service Providers
N 1835X0200X Pharmacist
Specialization: Oncology
RPH-0013207 OR Pharmacy Service Providers

Office Location

Street Address 1700 E 19TH ST
City THE DALLES
State OR
Zip Code 97058-3317

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306842752 Mid-columbia Medical Center General Acute Care Hospital 1700 E 19th St, The Dalles, OR 97058-3317 2005-06-21
1851999866 Michelle Burnett Specialist/Technologist, Other 1700 E 19th St, The Dalles, OR 97058-3317 2020-10-12
1821569286 Nader Saad Pharmacist 1700 E 19th St, The Dalles, OR 97058-3398 2018-12-11
1821581430 Timbus Anesthesiology, LLC Anesthesiology 1700 E 19th St, The Dalles, OR 97058-3317 2018-06-08
1205338084 Maricela Elena Bandel-ramirez Hospitalist 1700 E 19th St, The Dalles, OR 97058 2018-03-07
1922551381 Tim P Bondarenko Pharmacist 1700 E 19th St, The Dalles, OR 97058-3317 2016-08-02
1487035945 Jaskeerat Singh Internal Medicine 1700 E 19th St, The Dalles, OR 97058 2015-06-10
1053708297 Columbia River Radiology, PC Radiology 1700 E 19th St, The Dalles, OR 97058-3317 2015-04-24
1114320199 Rachel Hopkins Pharmacist 1700 E 19th St, The Dalles, OR 97058-3317 2014-10-03
1639585813 Spencer P Nagle Internal Medicine 1700 E 19th St, The Dalles, OR 97058 2014-07-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538646864 Ashlee Kai Mcnamara Behavior Technician 2525 W 8th St., #34, The Dalles, OR 97058 2018-07-19
1548784689 Mireya Moreno Ibarra Behavior Technician 401 East 3rd Street, Suite 101, The Dalles, OR 97058 2017-07-31
1407304991 Joshua Seidel Pharmacist 515 Mt Hood St, The Dalles, OR 97058 2016-09-14
1366809048 Mid-columbia Medical Center Surgery 1810 E. 19th St. #225, The Dalles, OR 97058 2016-01-26
1558731141 Louise Goodnight Case Manager/Care Coordinator 419 East 7 Th Street, The Dalles, OR 97058 2015-09-25
1578944666 Jessica Donnell Dental Hygienist 2529 E 12th St, The Dalles, OR 97058 2015-06-15
1487034328 Savanna Schaan Specialist 609 W 14th St, The Dalles, OR 97058 2015-06-05
1801299102 Mary E Zenorini Social Worker 1620 E. 12th St, The Dalles, OR 97058 2014-09-30
1669889143 Diane Joan Irwin Social Worker 419 E 7th St #207, The Dalles, OR 97058 2014-07-17
1124452008 Lacey A Nichols Counselor 312 E. Third St., The Dalles, OR 97058 2013-08-27
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Taxonomy Information

Taxonomy Code 1835P0018X
Grouping Pharmacy Service Providers
Classification Pharmacist
Specialization Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962656785 Sean Malone Fitzpatrick Pharmacist 1215 W 6th St, The Dalles, OR 97058-3515 2008-11-06
1578719902 Eric Paul Holeman Pharmacist 1700 E 19th St, The Dalles, OR 97058-3317 2008-08-18

Providers in the same taxonomy and state

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
1144737677 Matthew Ito Pharmacist 5805 Sw Delker Rd, Tualatin, OR 97062-7753 2018-01-05
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
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Competitor

Search similar providers

City THE DALLES
Zip Code 97058

Improve Information

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Dataset Information

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.

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