Active NPI
Diane Pham, PHARM.D.
- Pharmacist
- Beaverton, OR
National Provider Identifier
1003159575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH0013429
- Practice address
- 14625 SW Allen Blvd
Beaverton, OR 97007-3697 - Phone
- (714) 204-9190
- NPI assigned
- Apr 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH0013429 | OR | Primary |
Addresses
Primary practice location
14625 SW Allen Blvd
Beaverton, OR 97007-3697
Mailing address
14625 SW Allen Blvd
Beaverton, OR 97007-3697
Phone (714) 204-9190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH0013429 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364860800000",
"number": "1003159575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14625 SW ALLEN BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970073697",
"telephone_number": "714-204-9190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14625 SW ALLEN BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970073697",
"telephone_number": "714-204-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "DIANE",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-02",
"last_updated": "2013-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH0013429",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.