Active NPI
Vance Haines
- Pharmacist
- Lebanon, OR
National Provider Identifier
1114897378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0020807
- Practice address
- 3290 S Santiam Hwy
Lebanon, OR 97355-3737 - Phone
- (541) 841-9462
- NPI assigned
- Nov 11, 2025
- 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-0020807 | OR | Primary |
Addresses
Primary practice location
3290 S Santiam Hwy
Lebanon, OR 97355-3737
Mailing address
30721 Butte Creek Rd
Lebanon, OR 97355-9238
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-0020807 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762819200000",
"number": "1114897378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30721 BUTTE CREEK RD",
"city": "LEBANON",
"state": "OR",
"postal_code": "973559238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3290 S SANTIAM HWY",
"city": "LEBANON",
"state": "OR",
"postal_code": "973553737",
"telephone_number": "541-841-9462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "VANCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-11-11",
"last_updated": "2025-11-11",
"certification_date": "2025-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0020807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.