Active NPI
Jenelle Lynn Stinson, PHARMD
- Pharmacist
- Portland, OR
National Provider Identifier
1023620770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0014143
- Practice address
- 1015 NW 22ND Ave
Portland, OR 97210-3025 - Phone
- (503) 413-7008
- NPI assigned
- Aug 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 0014143 | OR | Primary |
Addresses
Primary practice location
1015 NW 22ND Ave
Portland, OR 97210-3025
Mailing address
15875 SE Harold Ave
Portland, OR 97267-3947
Phone (503) 475-3206
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 |
|---|---|---|---|
| 0014143 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598054400000",
"number": "1023620770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15875 SE HAROLD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972673947",
"telephone_number": "503-475-3206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 NW 22ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972103025",
"telephone_number": "503-413-7008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STINSON",
"first_name": "JENELLE",
"middle_name": "LYNN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-22",
"last_updated": "2020-08-22",
"certification_date": "2020-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "0014143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.