Individual provider Active NPI

Nastja Rebrin

  • Institutional Pharmacy
  • Portland, OR
National Provider Identifier
1508454026
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Practice address
1105 NE Meadow Dr
Portland, OR 97211-1215
Phone
(626) 664-9303
NPI assigned
Jan 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X Primary

Addresses

Primary practice location

1105 NE Meadow Dr
Portland, OR 97211-1215

Mailing address

1105 NE Meadow Dr
Portland, OR 97211-1215
Phone (626) 664-9303

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

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1508454026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 NE MEADOW DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972111215",
            "telephone_number": "626-664-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 NE MEADOW DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972111215",
            "telephone_number": "626-664-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBRIN",
        "first_name": "NASTJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "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 Jan 10, 2021; 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.