Susanna Lyn Dube, PHARM D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

0010715 Issued in OR

Practice address

3300 Portland Rd
Newberg, OR 97132-5400

Phone

(503) 537-1383

Fax

(503) 537-1377

NPI assigned

Jan 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fred Meyer Stores Inc.

  • Community/Retail Pharmacy
  • Lynnwood, WA
  • NPI 1558235762
  NPD (past)

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1104164433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 PORTLAND RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971325400",
            "telephone_number": "503-537-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PORTLAND RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971325400",
            "telephone_number": "503-537-1383",
            "fax_number": "503-537-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "SUSANNA",
        "middle_name": "LYN",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0010715",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 00039967",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0010715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Marsha a. Green, L.L.C.
• Dr. Mojica Therapy LLC
• James Rollin Draeger, L.P.C.
• Dragonfly Massge LLC
• Garrett Drake
• Carol Dugan, LPC I
• Claire Elizabeth Duisenberg
• Brian Richard Duncan, M.D.
• Madison K Duppenthaler, MD
• Mary Bel Duran, RN

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Newberg, OR
• Providers in Newberg, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.