Charles Whitney Bodreau, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

0016852 Issued in OR

Practice address

20233 SW Jay St
Aloha, OR 97003-8137

Phone

(971) 221-8200

NPI assigned

Jul 15, 2020

Last updated

Jul 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Interoperability endpoints

• Direct secure messaging: cbodreau780365@direct.ochin.org

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1255949285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20233 SW JAY ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970038137",
            "telephone_number": "971-221-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20233 SW JAY ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970038137",
            "telephone_number": "971-221-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODREAU",
        "first_name": "CHARLES",
        "middle_name": "WHITNEY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0016852",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0016852",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "KY",
            "license": "021408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Lauren Bish, BA
• Lisa Bizon
• Erin Black
• Kenneth Erwin Blake, D.M.D.
• Paul D Blaylock, MD
• Lee Bostwick
• Gabrielle A.R. Box
• Barbara Anne Boyd
• Joshua Boyer
• Paul D Brent, D.D.S.

• Pharmacist in Aloha, OR
• Providers in Aloha, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.