Active NPI
Heejoo Song
- Pharmacist
- Wilsonville, OR
National Provider Identifier
1033947593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0020071
- Practice address
- 25925 SW Heather PL
Wilsonville, OR 97070-5785 - Phone
- (503) 682-7793
- NPI assigned
- Jul 24, 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 | 0020071 | OR | Primary |
Addresses
Primary practice location
25925 SW Heather PL
Wilsonville, OR 97070-5785
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6195
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0020071 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1033947593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25925 SW HEATHER PL",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970705785",
"telephone_number": "503-682-7793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "HEEJOO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-24",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "0020071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilsonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.