Edyth Adele Willard, PHARM D

Primary specialty

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

License

5654 Issued in OR

Practice address

4531 SE Belmont St
Suite 100
Portland, OR 97215-1675

Phone

(503) 215-8774

NPI assigned

Jun 30, 2005

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1154328664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "503-215-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "503-215-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "EDYTH",
        "middle_name": "ADELE",
        "name_prefix": "Ms.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "WA",
            "license": "11799",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "5654",
            "primary": true
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "OR",
            "license": "5654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willamette Valley Iom, LLC
• Willamette View Inc.
• Willamette Wine Spa LLC
• Michelle Willams, M.D.
• Sherri Willard Argyres
• Gregory Willard, DC
• Carol Shychy Willeford, PMHNP
• Catherine Willeford
• Vincent A Willeford, MD
• Michael B Willet, M.D.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Portland, OR
• Providers in Portland, 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 Oct 12, 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.

Verify at the official NPI Registry.