DR. DEREK MATLOCK (NPI# 1982110805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982110805 |
Entity Type | Individual |
Full Name | DR. DEREK MATLOCK |
Credential | PHARM.D. |
Practice Address |
3715 Ocean Beach Hwy # 2 Longview WA 98632-4801 |
Practice Telephone | 3603553082 |
Mailing Telephone | 3603553082 |
Enumeration Date | 2017-12-15 |
Last Update Date | 2017-12-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH60758206 | WA | Pharmacy Service Providers |
Street Address |
3715 OCEAN BEACH HWY # 2 |
City | LONGVIEW |
State | WA |
Zip Code | 98632-4801 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
Find all providers in zip 98632 |
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 |
---|---|---|---|---|
1750912796 | Grishma Patel | Pharmacist | 701 W Marshall Ave, Longview, TX 75601-6218 | 2020-01-29 |
1952947327 | James David Burgan | Pharmacist | 511 E Marshall Ave, Longview, TX 75601-5425 | 2019-11-20 |
1134626468 | Daniel Richard Sharp | Pharmacist | 1230 7th Ave, Longview, WA 98632-3166 | 2018-04-12 |
1427508985 | Katherine Johanson | Pharmacist | 1230 7th Ave, Longview, WA 98632-3166 | 2016-10-09 |
1447686514 | Jared Koyle | Pharmacist | 701 W Marshall Ave, Longview, TX 75601-6218 | 2013-09-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891395760 | Evelyn Tong | Pharmacist | 4229 122nd Ave Se, Bellevue, WA 98006-1915 | 2020-10-29 |
1356985345 | Nancy Celine Tran | Pharmacist | 906 S 38th Ct, Renton, WA 98055-5897 | 2019-11-01 |
1265087654 | Valorie Swensen | Pharmacist | 4500 Harrison St, Bellingham, WA 98229-3323 | 2019-08-02 |
1659880938 | Hazel Ann Feist | Pharmacist | 14406 Nw 20th Ave, Vancouver, WA 98685-8007 | 2017-09-29 |
1528586732 | Mayumi Robbins | Pharmacist | 410 9th Ave N Fl 7, Seattle, WA 98109-4708 | 2017-09-07 |
1699293688 | Jin Man Choe | Pharmacist | 105 W 8th Ave Ste 350, Spokane, WA 99204-2312 | 2017-08-30 |
1821457813 | Marie Cermak | Pharmacist | 12333 Ne 130th Ln # Lane415, Kirkland, WA 98034-7467 | 2016-02-18 |
1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
1639574981 | Loi Chau | Pharmacist | 601 Broadway Rm 117, Seattle, WA 98122-5330 | 2014-10-29 |
1023410750 | Danny Dang | Pharmacist | 64 Rainier Ave S Ste H, Renton, WA 98057-2047 | 2014-09-25 |
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.