Gary M Bold, RPH
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Canby, OR
NPI 1356595656 · NPPES record last updated Mar 18, 2021
Key facts
- NPI
- 1356595656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- RPH-0005847 (OR)
- Practice address
- 1080 SW 1St Ave
Canby, OR 97013-3828 - Phone
- (503) 263-1600
- NPI assigned
- Nov 13, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0005847 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0005847 | OR | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH-0005847 | OR | Yes |
Addresses
Primary practice location
1080 SW 1St Ave
Canby, OR 97013-3828
Mailing address
1080 SW 1St Ave
Canby, OR 97013-3828
Phone (503) 263-1600
Other providers in Canby, OR
- Daniel Birt
- Jennifer Bissig
- Anna Fehm Blake
- Dianne Eileen Blust
- Tyler Marc Bohnet
- Misty M Bonham
- Briana Nichole Booth
- Zachary Borden
- Sihely Borycens
- Bountiful Health Family Medicine, LLC
All providers in Canby, OR · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.