SATTA JIVAGUNCHAINAN (NPI# 1598211393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598211393 |
| Entity Type | Individual |
| Full Name | SATTA JIVAGUNCHAINAN |
| Practice Address |
1111 Ne 102nd Ave Portland OR 97220-3902 |
| Mailing Address |
7404 N Interstate Ave Portland OR 97217-5528 |
| Practice Telephone | 5032555494 |
| Mailing Telephone | 5032866784 |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2017-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH-0015543 | OR | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
15543 | OR | Pharmacy Service Providers |
| Street Address |
1111 NE 102ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174560205 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2006-05-31 |
| 1811500432 | Ada Li | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2020-08-24 |
| 1083244412 | Tiffany Pham | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2020-01-24 |
| 1801284427 | Quan Tran | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2015-01-05 |
| 1497164636 | Muey Saechao | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2014-08-12 |
| 1487929394 | Jessie Chan | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2012-03-12 |
| 1295000123 | Sharon Chin | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2012-03-10 |
| 1336441138 | Lam Thuy Kieu | Pharmacist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2010-11-30 |
| 1669500278 | Jill Scheiffele | Optometrist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2007-03-02 |
| 1972644490 | Margaret Mary Piatz Benck | Optometrist | 1111 Ne 102nd Ave, Portland, OR 97220-3902 | 2007-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1245695956 | M. Katherine Welch | Pharmacist | 3228 Sw Water Ave, Portland, OR 97239-4632 | 2015-12-22 |
| 1790176006 | Jacob Tang | Pharmacist | 1940 Se 12th Ave Apt 9, Portland, OR 97214-4779 | 2015-02-09 |
| 1902211196 | Danit Chetron | Pharmacist | 2323 Sw Caldew St, Portland, OR 97219-2618 | 2014-06-25 |
| 1023350881 | Joey Goren Degrood | Pharmacist | 9044 Sw Rystadt Ln, Portland, OR 97225-2851 | 2013-03-20 |
| 1831435213 | James L Huang | Pharmacist | 300 N Graham St Ste 200, Portland, OR 97227 | 2012-12-12 |
| 1972853331 | Sharon Leigh | Pharmacist | 4531 Se Belmont St. Suite 100, Portland, OR 97215-1675 | 2012-09-13 |
| 1649544107 | Ryan Bradley | Pharmacist | 6348 Ne Halsey St Ste A, Portland, OR 97213-4720 | 2012-03-01 |
| 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.