NPIMap

Organization Active NPI

Isse Pharmacy Services

  • Long Term Care Pharmacy
  • Clackamas, OR
National Provider Identifier
1225464118
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
RP-0002831 Issued in OR
Legal business name
ISSE PHARMACY SERVICES
Practice address
15635 SE 114TH Ave Ste 101
Clackamas, OR 97015-9028
Phone
(503) 908-0630
Fax
(503) 908-0865
NPI assigned
Sep 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Dr. Jared Isse, PHARMDNPI 1578990065
Title
Owner/Pharmacist
Phone
(503) 908-0630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X RP-0002831 OR Primary

Addresses

Primary practice location

15635 SE 114TH Ave Ste 101
Clackamas, OR 97015-9028

Mailing address

15635 SE 114TH Ave Ste 101
Clackamas, OR 97015-9028
Phone (503) 908-0630

Other identifiers 2

IdentifierTypeStateIssuer
2142223OtherPK
500667941MedicaidOR

National Provider Directory

National Provider Directory

Locations

15635 SE 114th Ave
Ste 101
Clackamas, OR 97015
Phone (503) 908-0630

15812 SE 114th Ave
Clackamas, OR 97015
Phone (503) 449-2651

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1225464118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15635 SE 114TH AVE STE 101",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159028",
            "telephone_number": "503-908-0630",
            "fax_number": "503-908-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15635 SE 114TH AVE STE 101",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159028",
            "telephone_number": "503-908-0630",
            "fax_number": "503-908-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISSE PHARMACY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "ISSE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "503-908-0630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OR",
            "license": "RP-0002831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142223",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500667941",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.