Active NPI
Courtney Lynn Vanbriesen, PHARMD.
- Pharmacist
- Portland, OR
National Provider Identifier
1093097768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22129
- Practice address
- 2800 SE Hawthorne Blvd
Portland, OR 97214-2945 - Phone
- (503) 232-3930
- NPI assigned
- Sep 19, 2011
- 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 | 22129 | NC | Primary |
Addresses
Primary practice location
2800 SE Hawthorne Blvd
Portland, OR 97214-2945
Mailing address
2800 SE Hawthorne Blvd
Portland, OR 97214-2945
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22129 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354147200000",
"number": "1093097768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 SE HAWTHORNE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 SE HAWTHORNE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142945",
"telephone_number": "503-232-3930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANBRIESEN",
"first_name": "COURTNEY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARMD.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-19",
"last_updated": "2012-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "22129",
"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 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.