Madeleine Suzanne Bullick Grant, PHARMD

Primary specialty

Psychiatric PharmacistTaxonomy code 1835P1300X

License

RPH6254 Issued in ND

Practice address

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Phone

(503) 220-8262

NPI assigned

Sep 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1245953272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 NE MLK BLVD APT 523",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322095",
            "telephone_number": "651-212-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MADELEINE",
        "middle_name": "SUZANNE BULLICK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "ND",
            "license": "RPH6254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "madeleine.grant1@va.gov",
            "affiliation": "N",
            "endpointDescription": "VA email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3710 SW US Veterans Hospital Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972392964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Grant, LPC, ATR
• Jordan Alyssa Grant
• Kylie Morgan Grant
• Lora Grant
• Lyntressa Danielle Grant, PMHNP-BC
• Mary E Grant, ANP
• Melanie Janelle Grant, DMD
• Michael Grant
• Nancy Grant, M.D.
• Rowan M Grant

• Psychiatric Pharmacist in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.