Individual provider Active NPI

Jessica Dove Holsen, PHARMD, MBA

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Corvallis, OR
National Provider Identifier
1225892482
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH-0019575 Issued in OR
Practice address
2300 NW Walnut Blvd
Corvallis, OR 97330-3538
Phone
(541) 768-6554
Fax
(541) 768-5210
NPI assigned
Feb 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH-0019575 OR Primary

Addresses

Primary practice location

2300 NW Walnut Blvd
Corvallis, OR 97330-3538

Mailing address

2300 NW Walnut Blvd Lowr Level
Corvallis, OR 97330-3538
Phone (541) 215-2411

Other practice location 1

441 NW Elks Dr Ste 100
Corvallis, OR 97330-3744
Phone (541) 768-6554

Other practice location 2

3620 NW Samaritan Dr Ste 202
Corvallis, OR 97330-3785
Phone (541) 768-6554

Other identifiers 2

IdentifierTypeStateIssuer
RPH-0019575-POtherORPRECEPTOR
RPH-0019575OtherORPHARMACIST LICENSE

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
Master of Business Administration, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH-0019575ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1225892482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 NW WALNUT BLVD LOWR LEVEL",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303538",
            "telephone_number": "541-215-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 NW WALNUT BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303538",
            "telephone_number": "541-768-6554",
            "fax_number": "541-768-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 NW Elks Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303744",
            "country_code": "US",
            "telephone_number": "541-768-6554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3620 NW Samaritan Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303785",
            "country_code": "US",
            "telephone_number": "541-768-6554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLSEN",
        "first_name": "JESSICA",
        "middle_name": "DOVE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0019575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRECEPTOR",
            "identifier": "RPH-0019575-P",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "RPH-0019575",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.