Individual provider Active NPI

Fetuao Turner, PHARMD

  • Pharmacist
  • Portland, OR
National Provider Identifier
1073081246
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0012854 Issued in OR
Practice address
5329 NE MLK Jr Blvd
Second Floor/Pharmacy
Portland, OR 97211
Phone
(503) 988-3634
Fax
(503) 988-3839
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0012854 OR Primary

Addresses

Primary practice location

5329 NE MLK Jr Blvd
Second Floor/Pharmacy
Portland, OR 97211

Mailing address

5329 NE MLK Jr Blvd
Second Floor/Pharmacy
Portland, OR 97211
Phone (503) 988-3634

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

LicenseStateTypeSpecialty
RPH-0012854ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1073081246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5329 NE MLK JR BLVD",
            "address_2": "SECOND FLOOR/PHARMACY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97211",
            "telephone_number": "503-988-3634",
            "fax_number": "503-988-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 NE MLK JR BLVD",
            "address_2": "SECOND FLOOR/PHARMACY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97211",
            "telephone_number": "503-988-3634",
            "fax_number": "503-988-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "FETUAO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0012854",
            "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 Nov 6, 2018; 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.