DR. TREVOR JENNEWINE (NPI# 1538559331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538559331 |
| Entity Type | Individual |
| Full Name | DR. TREVOR JENNEWINE |
| Credential | RPH |
| Practice Address |
1990 14th Ave Se Albany OR 97322-8504 |
| Mailing Address |
2665 Nw Garryanna Dr 2 Corvallis OR 97330-3686 |
| Practice Telephone | 5418122386 |
| Mailing Telephone | 9376545025 |
| Enumeration Date | 2015-01-31 |
| Last Update Date | 2015-12-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH-0014533 | OR | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
0014533 | OR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON BOARD OF PHARMACY | RPH-0014533 | 01 |
| Street Address |
1990 14TH AVE SE |
| City | ALBANY |
| State | OR |
| Zip Code | 97322-8504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023047065 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 1990 14th Ave Se, Albany, OR 97322-8504 | 2006-07-02 |
| 1093194029 | Michele Mahealani Wofford | Pharmacist | 1990 14th Ave Se, Albany, OR 97322-8504 | 2015-05-22 |
| 1891100103 | Terrance Loo | Pharmacist | 1990 14th Ave Se, Albany, OR 97322-8504 | 2014-06-25 |
| 1366857716 | Diane Nauman | Pharmacist | 1990 14th Ave Se, Albany, OR 97322-8504 | 2014-06-24 |
| 1306196647 | Michael Oliver | Pharmacist | 1990 14th Ave Se, Albany, OR 97322-8504 | 2012-09-13 |
| 1124320064 | Sherry Leann Fields | Pharmacist | 1990 14th Ave Se, Albany, OR 97322-8504 | 2010-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083109748 | Benjamin Voth | Counselor | 1858 Grand Prairie Rd Se, Albany, OR 97322 | 2018-06-26 |
| 1033534748 | Willamette Orthotics & Prosthetics, LLC | Durable Medical Equipment & Medical Supplies | 1630 9th Ave Se, Albany, OR 97322 | 2014-03-04 |
| 1699035998 | Morgan William Brown | Behavioral Analyst | 1885 21 St Ave Se Apt 44, Albany, OR 97322 | 2012-05-21 |
| 1780986059 | Gene Vang | Pharmacist | 1330 Goldfish Farm Rd Se, Albany, OR 97322 | 2010-11-18 |
| 1427362912 | Kate Fredrickson | Speech-Language Pathologist | 5353 Columbus St. Se, Albany, OR 97322 | 2010-07-27 |
| 1689906455 | Sandy Janiszewski | Registered Nurse | 1970 4th Ave. Se, Ste 120, Albany, OR 97322 | 2010-02-04 |
| 1841527066 | Karina Leonore Towers | Speech-Language Pathologist | 5353 Columbus Street Se, Albany, OR 97322 | 2009-11-09 |
| 1548497951 | T.c.s. Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3012 Se Oakwood Avenue, Albany, OR 97322 | 2009-06-12 |
| 1790932952 | Ramel C Romero | Physical Therapist | 5353 Colombus St Se, Albany, OR 97322 | 2008-08-19 |
| 1023275492 | Michael James | Hearing Instrument Specialist | 1610 9th Av. Se, Albany, OR 97322 | 2008-05-21 |
| Find all providers in zip 97322 | ||||
| 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 |
|---|---|---|---|---|
| 1811373772 | Katrin M Ridge | Pharmacist | 1010 7th Ave. Sw., Albany, OR 97321 | 2015-08-03 |
| 1982245452 | Cheryl Ann Hanslovan | Pharmacist | 1046 6th Ave Sw, Albany, OR 97321-1916 | 2019-10-04 |
| 1760960801 | Sara Evanko | Pharmacist | 2272 Santiam Hwy Se, Albany, OR 97322-5205 | 2018-07-31 |
| 1346748712 | Jan Matherne Lantrip | Pharmacist | 29148 South Montpelier Ave, Albany, LA 70711-0328 | 2018-01-31 |
| 1154867810 | Chelsea Bond | Pharmacist | 400 Hickory St Nw, Albany, OR 97321-1700 | 2017-01-18 |
| 1982076022 | Jeremy Boyd Theobald | Pharmacist | 1010 7th Ave Sw, Albany, OR 97321-1922 | 2015-10-28 |
| 1902296544 | Esther Chon | Pharmacist | 12 Jupiter Ln, Albany, NY 12205-6918 | 2015-02-04 |
| 1184067167 | Vanessa J Tedisch | Pharmacist | 1046 6th Ave Sw, Albany, OR 97321-1916 | 2013-04-09 |
| 1679832927 | Tiffany Gitt | Pharmacist | 1700 Geary St Se, Albany, OR 97322-6842 | 2012-05-07 |
| 1487977955 | Colby Mitchell | Pharmacist | 43 New Scotland Ave, Mc85, Albany, NY 12208-3412 | 2010-03-11 |
| Find all providers in ALBANY | ||||
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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.