Active NPI
Dylan Van Rooyen
- Pharmacist
- Salem, OR
National Provider Identifier
1104508555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0019612
- Practice address
- 3740 Market St NE
Salem, OR 97301-1826 - Phone
- (503) 370-4351
- NPI assigned
- Aug 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | RPH-0019612 | OR | Primary |
Addresses
Primary practice location
3740 Market St NE
Salem, OR 97301-1826
Mailing address
3740 Market St NE
Salem, OR 97301-1826
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-0019612 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1104508555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3740 MARKET ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973011826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3740 MARKET ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973011826",
"telephone_number": "503-370-4351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN ROOYEN",
"first_name": "DYLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-04",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0019612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
- Kristopher Van Huss
- Jeffrey Scott Van Kirk, D.M.D.
- Camilla Lynn Van Leuven, LMT
- Stephanie Van Orden, PSYD
- Julie Lynne Miller Van Otterloo, RPH
- Nathen Tyler Van Slochteren, B.S.
- Christiaan Johannes Van Vliet, LDO
- Haley Van Volkenburg, DMD
- Chandree Leigh Van Vranken, DPT
- Rupert Talmage Van Wormer, PHD, MSW, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.