Active NPI
Min Kyung Coblyn, PHARM. D.
- Pharmacist
- Beaverton, OR
National Provider Identifier
1265831283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0016489
- Practice address
- 14625 SW Allen Blvd
Beaverton, OR 97007-3697 - Phone
- (503) 643-2724
- NPI assigned
- Aug 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
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-0016489 | OR | Primary |
Addresses
Primary practice location
14625 SW Allen Blvd
Beaverton, OR 97007-3697
Mailing address
339 NE 105TH Ave
Hillsboro, OR 97006-7638
Phone (503) 720-8588
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-0016489 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1265831283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 NE 105TH AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "970067638",
"telephone_number": "503-720-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14625 SW ALLEN BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970073697",
"telephone_number": "503-643-2724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBLYN",
"first_name": "MIN KYUNG",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0016489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.