Active NPI
Jeffrey K Goldstein, RPH
- Pharmacist
- Portland, OR
National Provider Identifier
1174529994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0017235
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH60102 | CA | MD | Pharmacist |
| RPH-0017235 | OR | MD | Pharmacist |
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.