NPIMap

Individual provider Active NPI

Mallory Alyse Kempton-Hein, PHARMD

  • Pharmacist
  • Tigard, OR
National Provider Identifier
1366948465
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0016025 Issued in OR
Practice address
11956 SW Garden PL
Tigard, OR 97223-8248
Phone
(503) 941-3807
Fax
(503) 941-3809
NPI assigned
Apr 5, 2018
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 60901499 WA
Pharmacist 183500000X 116592 AK
Pharmacist 183500000X 75604 CA
Pharmacist 183500000X 0016025 OR Primary

Addresses

Primary practice location

11956 SW Garden PL
Tigard, OR 97223-8248

Mailing address

11956 SW Garden PL
Tigard, OR 97223-8248
Phone (503) 941-3807

Other practice location 1

6378 Commerce Blvd
Rohnert Park, CA 94928-2404
Phone (707) 586-3494

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
116592AKMDPharmacist
75604CAMDPharmacist
0016025ORMDPharmacist
60901499WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California LLC Past Accepting new patients
Longs Drug Store California LLC Past Accepting new patients
Zoom Care PC PastSince Aug 2, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mallory.kempton-hein.1@30646.direct.athenahealth.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1366948465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11956 SW GARDEN PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238248",
            "telephone_number": "503-941-3807",
            "fax_number": "503-941-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11956 SW GARDEN PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238248",
            "telephone_number": "503-941-3807",
            "fax_number": "503-941-3809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6378 Commerce Blvd",
            "address_purpose": "LOCATION",
            "city": "Rohnert Park",
            "state": "CA",
            "postal_code": "949282404",
            "country_code": "US",
            "telephone_number": "707-586-3494",
            "fax_number": "707-586-0735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEMPTON-HEIN",
        "first_name": "MALLORY",
        "middle_name": "ALYSE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "60901499",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "116592",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "75604",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0016025",
            "primary": true
        }
    ],
    "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 Jan 31, 2024; 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.