Active NPI
Brenda Lee Hansen, PHARMD
- Pharmacist
- Brookings, OR
National Provider Identifier
1003677576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P11119
- Practice address
- 325 5TH St
Brookings, OR 97415-9656 - Phone
- (541) 469-1643
- NPI assigned
- Jan 22, 2024
- 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 | P11119 | ID | Primary |
Addresses
Primary practice location
325 5TH St
Brookings, OR 97415-9656
Mailing address
7168 Vista Ridge Dr
Brookings, OR 97415-9105
Phone (208) 297-4728
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 |
|---|---|---|---|
| P11119 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1003677576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7168 VISTA RIDGE DR",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "974159105",
"telephone_number": "208-297-4728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 5TH ST",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "974159656",
"telephone_number": "541-469-1643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "BRENDA",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-22",
"last_updated": "2024-01-22",
"certification_date": "2024-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P11119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.