Individual provider Active NPI

Matthew Thompson Lennick, PHARM.D.

  • Pharmacist
  • Vancouver, WA
National Provider Identifier
1508107004
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
00051006 Issued in WA
Practice address
7101 NE 137TH Ave
Vancouver, WA 98682-4933
Phone
(503) 250-1944
NPI assigned
Mar 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0010269 OR
Pharmacist 183500000X 00051006 WA Primary

Addresses

Primary practice location

7101 NE 137TH Ave
Vancouver, WA 98682-4933

Mailing address

5717 NE 138TH Ave
Portland, OR 97230-3409
Phone (503) 250-1944

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
00051006WAMDPharmacist
0010269ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1508107004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 NE 138TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972303409",
            "telephone_number": "503-250-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 NE 137TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986824933",
            "telephone_number": "503-250-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNICK",
        "first_name": "MATTHEW",
        "middle_name": "THOMPSON",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0010269",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "00051006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.