Active NPI
Michael Joseph Peizner, PHARMACIST
- Pharmacist
- Clackamas, OR
National Provider Identifier
1487100756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7113
- Practice address
- 16300SE Evelyn Street
Clackamas, OR 97015 - Phone
- (503) 305-9700
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7113 | OR | Primary |
Addresses
Primary practice location
16300SE Evelyn Street
Clackamas, OR 97015
Mailing address
12072 SW Whistlers Loop
Tigard, OR 97223-2979
Phone (503) 590-0517
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 |
|---|---|---|---|
| 7113 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472342400000",
"number": "1487100756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12072 SW WHISTLERS LOOP",
"city": "TIGARD",
"state": "OR",
"postal_code": "972232979",
"telephone_number": "503-590-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16300SE EVELYN STREET",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "97015",
"telephone_number": "503-305-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEIZNER",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-28",
"last_updated": "2016-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "7113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.