DR. ANDREW R CANNING (NPI# 1417390634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417390634 |
| Entity Type | Individual |
| Full Name | DR. ANDREW R CANNING |
| Credential | PHARMD |
| Practice Address |
9605 Grand Ronde Rd Grand Ronde OR 97347-9712 |
| Practice Telephone | 5038792342 |
| Practice Fax Number | 5038792030 |
| Mailing Telephone | 5038792342 |
| Mailing Fax Number | 5038792030 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2019-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 390200000X | Student in an Organized Health Care Education/Training Program | PI-0010656 | OR | Student, Health Care |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0014295 | OR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OR PHARMACIST LICENSE | RPH-0014295 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1813 Sw 49th St, Appt. 174, Corvallis, OR 973333033 | 5417401150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760833925 | Andrew Robert Canning | Internal Medicine | 982055 Nebraska Medical Ctr, Omaha, NE 68198-2055 | 2016-06-28 |
| Street Address |
9605 GRAND RONDE RD |
| City | GRAND RONDE |
| State | OR |
| Zip Code | 97347-9712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932180734 | Lance Gregory Loberg | Family Medicine | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2005-11-08 |
| 1003286840 | Albert Martineau | Counselor | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2015-10-06 |
| 1104164359 | Confederated Tribes of Grand Ronde Community of Oregon Dba Gr Health & | Clinic/Center | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2013-01-23 |
| 1508111931 | Capitol Physical Therapy, Inc | Physical Therapist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2012-07-23 |
| 1477845352 | Jeanette Marie Kaschmitter | Counselor | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2011-05-10 |
| 1366765687 | George Ryan Davis | Dentist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2010-03-02 |
| 1467692350 | Ashley Rose Nunley | Chiropractor | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2009-03-05 |
| 1477711802 | Confederated Tribes of The Grand Ronde Community of Oregon | Pharmacy | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2008-06-02 |
| 1881875375 | Lincoln Wright | Pharmacist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-11-26 |
| 1417144387 | Myron T Peng | Dentist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023325859 | Linda 'lynn' Michelle House | Licensed Practical Nurse | 7650 Birch Street, Grand Ronde, OR 97347-0024 | 2010-08-31 |
| 1689700213 | Angela R Vargas | Counselor | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-02-26 |
| 1326513367 | Confederated Tribes of Grand Ronde Community of Oregon | Radiology | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2018-10-05 |
| 1922554542 | Terri Knowles | Optometrist | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2016-09-01 |
| 1093073439 | Nicole Marie Estrada | Counselor | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2012-04-23 |
| 1881970069 | Sarah J Ross | Speech-Language Pathologist | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2011-11-01 |
| 1073709499 | Erin Margaret Lange | Dentist | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-09-19 |
| 1477720365 | Martie M Coblentz | Contractor | 27725 Jahn Rd, Grand Ronde, OR 97347-9735 | 2008-05-11 |
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 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] |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RONDE |
| Zip Code | 97347 |
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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.