ANTHONY F. DEFAZIO (NPI# 1750654968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750654968 |
| Entity Type | Individual |
| Full Name | ANTHONY F. DEFAZIO |
| Credential | RPH |
| Practice Address |
17108 Se Powell Blvd Portland OR 97236-1753 |
| Practice Telephone | 5036675377 |
| Practice Fax Number | 5036669257 |
| Mailing Telephone | 5036675377 |
| Mailing Fax Number | 5036669257 |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2012-02-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH-0005733 | OR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | STATE PHARMACIST LICENSE | RPH-0005733 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962850198 | Anthony Defazio | Counselor | 1540 Rte 138 Ste 202, Wall, NJ 07719-3765 | 2016-05-27 |
| 1851332019 | Anthony J Defazio | Optometrist | 61 Beaver Dr, Du Bois, PA 15801-2401 | 2006-06-09 |
| Street Address |
17108 SE POWELL BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992738256 | Bimart Corporation | Durable Medical Equipment & Medical Supplies | 17108 Se Powell Blvd, Portland, OR 97236-1753 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460371 | Samantha Nozomi Murata | Pharmacist | 5415 Sw Beaverton Ct Hwy, Portland, OR 97221 | 2020-09-08 |
| 1053923920 | Hoang Lan Ngoc Doan | Pharmacist | 4201 Ne 129th Pl, Portland, OR 97230-1405 | 2020-08-20 |
| 1528677531 | Mi Pham | Pharmacist | 5824 Se 134th Pl, Portland, OR 97236-2987 | 2020-07-26 |
| 1700407350 | Emad Banoub | Pharmacist | 1105 Hyw 181, Portland, TX 78374 | 2020-05-05 |
| 1255951471 | Nam Lai | Pharmacist | 2655 Se 50th Ave Apt 415, Portland, OR 97206-1577 | 2020-04-17 |
| 1275167439 | Mayasah Anas Sedeeq Al Bazzaz | Pharmacist | 15122 Nw Fig Ln, Portland, OR 97229-6986 | 2020-02-26 |
| 1427696632 | Thai Tran | Pharmacist | 7901 Se Powell Blvd, Portland, OR 97206-2314 | 2019-12-18 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1952966970 | Linda P. Pham | Pharmacist | 7901 Se Powell Blvd Ste K, Portland, OR 97206-2314 | 2019-05-06 |
| 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.