Individual provider Active NPI

Jeffrey K Goldstein, RPH

  • Pharmacist
  • Portland, OR
National Provider Identifier
1174529994
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0017235 Issued in OR
Practice address
15 N Morris St
Portland, OR 97227-1541
Phone
(503) 230-9875
Fax
(503) 331-2677
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH60102 CA
Pharmacist 183500000X RPH-0017235 OR Primary

Addresses

Primary practice location

15 N Morris St
Portland, OR 97227-1541

Mailing address

1776 SW Madison St
Portland, OR 97205-1715
Phone (503) 224-1044

Other practice location 1

12360 E Burnside St
Portland, OR 97233-1042
Phone (971) 279-4800

Other practice location 2

Navajo Route 4
Pinon Health Center
Pinon, AZ 86510
Phone (928) 725-3220 ext. 69637

Other names 1

  • Jeff K Goldstein Other name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH60102CAMDPharmacist
RPH-0017235ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1174529994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N MORRIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271541",
            "telephone_number": "503-230-9875",
            "fax_number": "503-331-2677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12360 E Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972331042",
            "country_code": "US",
            "telephone_number": "971-279-4800",
            "fax_number": "971-279-2763",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Navajo Route 4",
            "address_2": "Pinon Health Center",
            "address_purpose": "LOCATION",
            "city": "Pinon",
            "state": "AZ",
            "postal_code": "86510",
            "country_code": "US",
            "telephone_number": "928-725-3220 x69637",
            "fax_number": "928-725-3613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JEFFREY",
        "middle_name": "K",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH60102",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0017235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFF",
            "last_name": "GOLDSTEIN",
            "middle_name": "K",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 6, 2021; 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.