Michael Ouanesisouk

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH-0019528 Issued in OR

Practice address

6850 N Lombard St
Portland, OR 97203-6247

Phone

(503) 240-2733

Fax

(503) 240-2724

NPI assigned

Jul 10, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fred Meyer Stores Inc

  dba Fred Meyer Pharmacy

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1811932981
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1033897145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036247",
            "telephone_number": "503-240-2733",
            "fax_number": "503-240-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036247",
            "telephone_number": "503-240-2733",
            "fax_number": "503-240-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUANESISOUK",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0019528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Joan Otto, LMT
• Lesley Nicoloff Otto, MD
• Madeline Otto, MD
• Kaytlin Ottofazi, BCBA
• Casondra Ottowa, RN
• Denis Ouchoro
• Cita C Oudijk, L.AC.
• Molly Ouellette, D.C.
• Robert Oun, ABOC, NCLC, LDO
• Our Inner Landscape

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.