Active NPI
Jacky Lee
- Critical Care Pharmacist
- Portland, OR
National Provider Identifier
1053050187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- RPH-0018922
- Practice address
- Ohsu Hospital
3181 SW Sam Jackson Park Rd
Portland, OR 97239 - Phone
- (503) 494-8311
- NPI assigned
- May 27, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Critical Care Pharmacist | 1835C0205X | RPH-0018922 | OR | Primary |
Addresses
Primary practice location
Ohsu Hospital
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
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 |
|---|---|---|---|
| RPH-0018922 | OR | MD | Critical Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671062400000",
"number": "1053050187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "OHSU HOSPITAL",
"address_2": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-8311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JACKY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-27",
"last_updated": "2022-12-15",
"certification_date": "2022-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "OR",
"license": "RPH-0018922",
"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 Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.