Individual provider Active NPI

Thanh Hien Thi Wang, PHARM.D.

  • Pharmacist
  • Portland, OR
National Provider Identifier
1508299249
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0013698 Issued in OR
Practice address
1040 NW 22ND Ave Ste 420
Portland, OR 97210-3062
Phone
(503) 406-3809
NPI assigned
Aug 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD14044 AR
Pharmacist 183500000X PH-3984 HI
Pharmacist 183500000X 1-105105 KS
Pharmacist 183500000X PH236427 MA
Pharmacist 183500000X 5302044409 MI
Pharmacist 183500000X 58312 TX
Pharmacist 183500000X PH0323 GU
Pharmacist 183500000X R-16582 OK
Pharmacist 183500000X 19109 AL
Pharmacist 183500000X 15203 NE
Pharmacist 183500000X 051299275 IL
Pharmacist 183500000X A1-0004894 DE
Pharmacist 183500000X P7416 ID
Pharmacist 183500000X 0013698 OR Primary

Addresses

Primary practice location

1040 NW 22ND Ave Ste 420
Portland, OR 97210-3062

Mailing address

1040 NW 22ND Ave Ste 420
Portland, OR 97210-3062
Phone (503) 406-3809

Other practice location 1

9775 SW Gemini Dr
Beaverton, OR 97008-7148
Phone (866) 202-4014

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
58312TXMDClinical Social Worker
19109ALMDPharmacist
PD14044ARMDPharmacist
A1-0004894DEMDPharmacist
PH0323GUMDPharmacist
PH-3984HIMDPharmacist
P7416IDMDPharmacist
051299275ILMDPharmacist
1-105105KSMDPharmacist
PH236427MAMDPharmacist
5302044409MIMDPharmacist
15203NEMDPharmacist
R-16582OKMDPharmacist
0013698ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1508299249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103062",
            "telephone_number": "503-406-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103062",
            "telephone_number": "503-406-3809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9775 SW Gemini Dr",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970087148",
            "country_code": "US",
            "telephone_number": "866-202-4014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "THANH HIEN",
        "middle_name": "THI",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD14044",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH-3984",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-105105",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH236427",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302044409",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "58312",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GU",
            "license": "PH0323",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "R-16582",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "19109",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "15203",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051299275",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0004894",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7416",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0013698",
            "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 Mar 3, 2020; 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.