Individual provider Active NPI

Adam Rory Saulles, PHARMD

  • Ambulatory Care Pharmacist
  • Portland, OR
National Provider Identifier
1508422486
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
RPH-0015338 Issued in OR
Practice address
6348 NE Halsey St
Portland, OR 97213-4720
Phone
(503) 962-1705
NPI assigned
May 15, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X RPH-0015338 OR Primary

Addresses

Primary practice location

6348 NE Halsey St
Portland, OR 97213-4720

Mailing address

6348 NE Halsey St Ste a
Portland, OR 97213-4720
Phone (503) 962-1705

Other identifiers 5

IdentifierTypeStateIssuer
PH60743255OtherWAWASHINGTON BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION
5302038969OtherMIMICHIGAN BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION
RPH-0015338OtherOROREGON BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION
0202215443OtherVAVIRGINIA BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION
T-14686OtherMSMISSISSIPPI BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION

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
RPH-0015338ORMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1508422486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6348 NE HALSEY ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134720",
            "telephone_number": "503-962-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6348 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134720",
            "telephone_number": "503-962-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULLES",
        "first_name": "ADAM",
        "middle_name": "RORY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OR",
            "license": "RPH-0015338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION",
            "identifier": "PH60743255",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION",
            "identifier": "5302038969",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION",
            "identifier": "RPH-0015338",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION",
            "identifier": "0202215443",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI BOARD OF PHARMACY PHARMACIST LICENSE CERTIFICATION",
            "identifier": "T-14686",
            "state": "MS"
        }
    ],
    "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 Jun 11, 2019; 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.