Active NPI
Shah N Malik, R.PH.
- Pharmacist
- Lake Oswego, OR
National Provider Identifier
1487956231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6052
- Practice address
- 17779 Lower Boones Ferry Rd
Lake Oswego, OR 97035-5237 - Phone
- (503) 675-2509
- Fax
- (503) 675-2512
- NPI assigned
- Nov 30, 2010
- Last updated
- Nov 30, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6052 | OR | Primary |
| Pharmacist | 183500000X | PH00010260 | WA |
Addresses
Primary practice location
17779 Lower Boones Ferry Rd
Lake Oswego, OR 97035-5237
Mailing address
17779 Lower Boones Ferry Rd
Lake Oswego, OR 97035-5237
Phone (503) 675-2509
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6052 | OR | MD | Pharmacist |
| PH00010260 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
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": "1291075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1487956231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17779 LOWER BOONES FERRY RD",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970355237",
"telephone_number": "503-675-2509",
"fax_number": "503-675-2512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17779 LOWER BOONES FERRY RD",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970355237",
"telephone_number": "503-675-2509",
"fax_number": "503-675-2512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIK",
"first_name": "SHAH",
"middle_name": "N",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-30",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "6052",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00010260",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
- Christina Michelle Mahoney, L.AC.
- Megan Mahony, LAC
- Makerspace Speech Language and Cognition
- Kristy Car Makowichuk, LPC, LMHC
- Aleksey Maksimov
- Melinda Rose Mallek, LMT
- Maureen Maloney-Schou, B.C.O.
- Maloney's Custom Ocular Prosthetics, Inc. (Maloney's Ocular Prosthetics)
- Manami Yamaguchi DMD LLC
- Aubrey Mann, MS SLP-CCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.