CREDENA HEALTH LLC (NPI# 1487696787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487696787 |
| Entity Type | Organization |
| Organization Name | CREDENA HEALTH LLC |
| Other Organization Name | CREDENA HEALTH PHARMACY OLYMPIA |
| Practice Address |
413 Lilly Rd Ne Mail Stop Llh10 Olympia WA 98506-5133 |
| Mailing Address |
Po Box 5936b Portland OR 97228-5133 |
| Practice Telephone | 3604937412 |
| Practice Fax Number | 3604935403 |
| Mailing Telephone | 3604937412 |
| Mailing Fax Number | 3604935403 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-08-28 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (DIRECTOR REIMB REGULATORY STRATEGY) |
| Authorized Official Telephone | 4255255392 |
| 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 |
PHAR.CF.60658956 | WA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2106972 | 01 |
| Other Name | Type Code |
|---|---|
| Credena Health Pharmacy Olympia | Doing Business As Name - Organization |
| PROVIDENCE ST PETER HOSPITAL 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 |
| 1225190408 | Credena Health LLC | Pharmacy | 9155 Sw Barnes Rd Ste 102, Portland, OR 97225-6625 | 2006-12-14 |
| 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 |
| 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 |
| Colorado Business Entities | CREDENA HEALTH LLC | 7376 Sw Durham Road, Portland, OR 97224 |
| Street Address |
413 LILLY RD NE MAIL STOP LLH10 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157674 | Michael J Menen | Internal Medicine | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2005-07-12 |
| 1558962209 | Anieska Timms | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-11-07 |
| 1134737653 | Ngoc-van Thi Tran | Speech-Language Pathologist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-07-21 |
| 1780292714 | Paola Von Oelffen | Student in an Organized Health Care Education/Training Program | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-07-15 |
| 1013542885 | Raffy Jatamosa | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-03-11 |
| 1811522766 | Kaman Lindgren | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-03-10 |
| 1497389886 | Phuong Le | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-02-25 |
| 1679107239 | Tamara Eklund | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-02-23 |
| 1598307878 | Alisa Singratanakul | Pharmacist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2019-10-08 |
| 1528615192 | Anh Phuong Ho | Pharmacist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2019-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| 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 |
|---|---|---|---|---|
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1528134707 | Mark It Pharmacy Inc | Pharmacy | 3525 Ensign Road Ne, Olympia, WA 98506 | 2006-11-28 |
| 1740202431 | Washington Cvs Pharmacy LLC | Pharmacy | 2925 Harrison Ave Nw, Olympia, WA 98502-2566 | 2006-07-24 |
| 1245263581 | Haggen Inc | Pharmacy | 1313 Cooper Point Rd Sw, Olympia, WA 98502-5729 | 2006-07-09 |
| 1154377786 | Haggen Opco North LLC | Pharmacy | 3520 Pacific Ave Se, Olympia, WA 98501-2121 | 2006-05-25 |
| 1396187613 | Samy's Drug Store Inc. | Pharmacy | 3525 Ensign Rd Ne, Suite H, Olympia, WA 98506-5065 | 2013-07-29 |
| 1114113602 | Sea Mar Community Health Centers | Pharmacy | 3030 Limited Ln Nw, Olympia, WA 98502-2704 | 2007-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700493533 | Doctors Pharmacy, LLC | Pharmacy | 65 Columbia Point Dr, Richland, WA 99352-4375 | 2020-09-25 |
| 1871105999 | Whidbey Island Public Hospital District | Pharmacy | 7 Ne Birch St, Coupeville, WA 98239-3132 | 2020-08-19 |
| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1811511454 | Kaiser Foundation Health Plan of Washington | Pharmacy | 189 Telegraph Rd, Bellingham, WA 98226-8079 | 2020-05-29 |
| 1548883630 | Capsule Seattle LLC | Pharmacy | 2033 6th Ave Ste 120, Seattle, WA 98121-2526 | 2020-05-22 |
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1174155345 | Kaiser Foundation Health Plan of Washington | Pharmacy | 2335 172nd Street Ne, Marysville, WA 98271 | 2020-02-06 |
| 1245861996 | Salish Integrative Medicine, Inc | Pharmacy | 3700 Pacific Hwy E Ste 100b, Fife, WA 98424-1160 | 2020-01-31 |
| 1700417854 | Prosser Southgate Pharmacy Inc | Pharmacy | 207 Canyon Drive, Prosser, WA 99350-1009 | 2020-01-28 |
| 1700423639 | Venkateswara LLC | Pharmacy | 515 Minor Ave Ste 120, Seattle, WA 98104-2138 | 2019-12-10 |
| Find all providers with the same taxonomy | ||||
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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.