Active NPI
Kirk Thomas Gates
- Pharmacy Technician
- Tigard, OR
National Provider Identifier
1356514145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- T-0011752
- Practice address
- 12065 SW Walnut St
Tigard, OR 97223-3033 - Phone
- (360) 790-2293
- NPI assigned
- Apr 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | T-0011752 | OR | Primary |
| Pharmacy Technician | 183700000X | VA00057147 | WA |
Addresses
Primary practice location
12065 SW Walnut St
Tigard, OR 97223-3033
Mailing address
12065 SW Walnut St
Tigard, OR 97223-3033
Phone (360) 790-2293
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-0011752 | OR | MD | Pharmacy Technician |
| VA00057147 | WA | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207872000000",
"number": "1356514145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12065 SW WALNUT ST",
"city": "TIGARD",
"state": "OR",
"postal_code": "972233033",
"telephone_number": "360-790-2293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12065 SW WALNUT ST",
"city": "TIGARD",
"state": "OR",
"postal_code": "972233033",
"telephone_number": "360-790-2293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "KIRK",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-11",
"last_updated": "2008-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "OR",
"license": "T-0011752",
"primary": true
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "WA",
"license": "VA00057147",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.