Carrie Widman, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

0012830 Issued in OR

Practice address

4025 Mercantile Dr Ste 110
Lake Oswego, OR 97035-2518

Phone

(035) 387-8167

NPI assigned

Sep 27, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Oregon CVS Pharmacy LLC

  • Pharmacy
  • Lake Oswego, OR
  • NPI 1063090710
  NPD
• Oregon CVS Pharmacy LLC

  • Pharmacy
  • Bend, OR
  • NPI 1497864771
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Salem, OR
  • NPI 1467630780
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1275816126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 MERCANTILE DR STE 110",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 MERCANTILE DR STE 110",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352518",
            "telephone_number": "035-387-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "CARRIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0012830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Susan White, DNP, PMHNP-BC
• Misty Dawn White, N.D.
• Rachel Diane White, MSW
• Whitney Black MD LLC
• Whole Systems Healthcare Lake Oswego Clinic
• Wikle Dentistry LLC
• Katrina Wilhelm, N.D.
• Amy N Wilken
• Denise Marie Wilkinson, MSPT
• Meaghan Wilkinson

• Pharmacist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.