Individual provider Active NPI

Victor Gonzalez, PHARMD

  • Pharmacist
  • Woodburn, OR
National Provider Identifier
1386973709
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-11817 Issued in OR
Practice address
1175 Mount Hood Ave.
Woodburn, OR 97071-9080
Phone
(503) 982-2000
Fax
(503) 982-7074
NPI assigned
Dec 14, 2009
Last updated
Dec 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-11817 OR Primary

Addresses

Primary practice location

1175 Mount Hood Ave.
Woodburn, OR 97071-9080

Mailing address

1175 Mount Hood Ave.
Woodburn, OR 97071-9080
Phone (503) 982-2000

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
RPH-11817ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1386973709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MOUNT HOOD AVE.",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719080",
            "telephone_number": "503-982-2000",
            "fax_number": "503-982-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MOUNT HOOD AVE.",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719080",
            "telephone_number": "503-982-2000",
            "fax_number": "503-982-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-11817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.