NPIMap

Organization Active NPI

Oregon Health and Science University

Doing business as OHSU Doernbecher Childrens Hosp. Pharmacy

  • Community/Retail Pharmacy
  • Portland, OR
National Provider Identifier
1053454645
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RP-0001639-CS Issued in OR
Legal business name
OREGON HEALTH AND SCIENCE UNIVERSITY
Doing business as
OHSU Doernbecher Childrens Hosp. Pharmacy
Practice address
700 SW Campus Dr Ste 7480
Portland, OR 97239-3107
Phone
(503) 418-5244
Fax
(503) 494-3506
NPI assigned
Feb 14, 2007
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
OREGON HEALTH AND SCIENCE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Kelly Anne Smith
Title
Vice President, Erc
Phone
(503) 494-8417

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X RP-0001639-CS OR
Community/Retail Pharmacy 3336C0003X RP-0001639-CS OR Primary
Institutional Pharmacy 3336I0012X RP-0001639-CS OR

Addresses

Primary practice location

700 SW Campus Dr Ste 7480
Portland, OR 97239-3107

Mailing address

3181 SW Sam Jackson Park Rd
Mail Code: CR9-4 Pharmacy Compliance
Portland, OR 97239-3011
Phone (503) 494-8007

Other identifiers 5

IdentifierTypeStateIssuer
2010102MedicaidWA
PH004 ORMedicaidAK
242111MedicaidOR
3842704OtherNCPDP
M8082300MedicaidID

Other names 1

  • OHSU Doernbecher Childrens Hosp. Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oregon Health Sciences University26 organizations share this tax ID, including this one
Part of
Oregon Health Sciences University

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

3181 SW Sam Jackson Park Rd
Ste Dch
Portland, OR 97239

700 SW Campus Dr
Ste 7480
Portland, OR 97239
Phone (503) 418-5244

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1053454645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE: CR9-4 PHARMACY COMPLIANCE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8007",
            "fax_number": "503-494-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW CAMPUS DR STE 7480",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393107",
            "telephone_number": "503-418-5244",
            "fax_number": "503-494-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON HEALTH AND SCIENCE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OREGON HEALTH AND SCIENCE UNIVERSITY",
        "enumeration_date": "2007-02-14",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT, ERC",
        "authorized_official_telephone_number": "503-494-8417"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OR",
            "license": "RP-0001639-CS",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP-0001639-CS",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "OR",
            "license": "RP-0001639-CS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010102",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH004 OR",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242111",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3842704",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8082300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OHSU Doernbecher Childrens Hosp. Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OHSU Doernbecher Childrens Hosp. Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 6, 2025; 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.