Active NPI
Viriyavong V Im, PHARM D
- Pharmacist
- Redmond, OR
National Provider Identifier
1255632931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0012304
- Practice address
- 1705 S Highway 97
Pharmacy
Redmond, OR 97756-9647 - Phone
- (541) 504-4166
- NPI assigned
- Nov 11, 2010
- Last updated
- Nov 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0012304 | OR | Primary |
Addresses
Primary practice location
1705 S Highway 97
Pharmacy
Redmond, OR 97756-9647
Mailing address
1705 S Highway 97
Pharmacy
Redmond, OR 97756-9647
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0012304 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289433600000",
"number": "1255632931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 S HIGHWAY 97",
"address_2": "PHARMACY",
"city": "REDMOND",
"state": "OR",
"postal_code": "977569647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 S HIGHWAY 97",
"address_2": "PHARMACY",
"city": "REDMOND",
"state": "OR",
"postal_code": "977569647",
"telephone_number": "541-504-4166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IM",
"first_name": "VIRIYAVONG",
"middle_name": "V",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-11",
"last_updated": "2010-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0012304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.