Individual provider Active NPI

Diane Marie Gahan, RPH

  • Pharmacist
  • Portland, OR
National Provider Identifier
1427274588
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0012534 Issued in OR
Practice address
315 SW 5TH Ave
Portland, OR 97204-1703
Phone
(503) 416-5963
NPI assigned
Apr 17, 2007
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHAP1019 AK
Pharmacist 183500000X RPH-0012534 OR Primary

Addresses

Primary practice location

315 SW 5TH Ave
Portland, OR 97204-1703

Mailing address

315 SW 5TH Ave # 900
Portland, OR 97204-1703
Phone (503) 416-5963

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PHAP1019AKMDPharmacist
RPH-0012534ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1427274588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 SW 5TH AVE # 900",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041703",
            "telephone_number": "503-416-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SW 5TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041703",
            "telephone_number": "503-416-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAHAN",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "PHAP1019",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0012534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.