Active NPI
Jennifer Dattke
- Pharmacist
- Bend, OR
National Provider Identifier
1497055768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP-00001016-CS
- Practice address
- 342 E Third St.
Bend, OR 97701 - Phone
- (541) 312-6486
- Fax
- (541) 312-6488
- NPI assigned
- Nov 2, 2010
- Sex
- Female
- 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 | RP-00001016-CS | OR | Primary |
Addresses
Primary practice location
342 E Third St.
Bend, OR 97701
Mailing address
342 E Third St.
Bend, OR 97701
Phone (541) 312-6486
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 |
|---|---|---|---|
| RP-00001016-CS | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1497055768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "342 E THIRD ST.",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-312-6486",
"fax_number": "541-312-6488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "342 E THIRD ST.",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-312-6486",
"fax_number": "541-312-6488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATTKE",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-02",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RP-00001016-CS",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.