Phillip Kotlyarevskiy, PHARM D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

0018247 Issued in OR

Practice address

7320 SW Hunziker Rd Ste 300
Tigard, OR 97223-2302

Phone

(503) 941-3033

NPI assigned

Jan 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1346830643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7320 SW Hunziker Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972232302",
            "country_code": "US",
            "telephone_number": "503-941-3077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTLYAREVSKIY",
        "first_name": "PHILLIP",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0018247",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0018247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy D. Kopet, PH.D.
• Juliet Allison Korngut
• Abraham Korpoh
• Petia Kortcheva
• Mary Leanore Kost
• Ashley Koulax
• Sara Kowalczyk, OTR/L, OTD, MHA
• Patricia Kozak, OD
• Frank J Kratochvil III, DDS
• Wiliam D Kreml

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tigard, OR
• Providers in Tigard, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.