Individual provider Active NPI

Kristen Rose Wendell, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Portland, OR
National Provider Identifier
1326457763
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
013296 Issued in OR
Practice address
17727 E Burnside St
Portland, OR 97233-4803
Phone
(503) 215-8774
NPI assigned
Aug 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 013296 OR Primary

Addresses

Primary practice location

17727 E Burnside St
Portland, OR 97233-4803

Mailing address

17727 E Burnside St
Portland, OR 97233-4803
Phone (503) 215-8774

Other names 1

  • Ms. Kristen Rose Buczynski Former name

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

LicenseStateTypeSpecialty
013296ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1326457763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334803",
            "telephone_number": "503-215-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334803",
            "telephone_number": "503-215-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELL",
        "first_name": "KRISTEN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "013296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BUCZYNSKI",
            "middle_name": "ROSE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.