Active NPI
Mitzie Althea Allen, PHARM.D.
- Pharmacotherapy Pharmacist
- Warm Springs, OR
National Provider Identifier
1508863317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 22933
- Practice address
- 1270 Kotnum Road
Warm Springs, OR 97761 - Phone
- (541) 553-2134
- Fax
- (541) 553-2481
- NPI assigned
- Jul 7, 2005
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 22933 | MA | Primary |
Addresses
Primary practice location
1270 Kotnum Road
Warm Springs, OR 97761
Mailing address
1270 Kotnum Road
Warm Springs, OR 97761
Phone (541) 553-2134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139290 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22933 | MA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508863317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 KOTNUM ROAD",
"city": "WARM SPRINGS",
"state": "OR",
"postal_code": "97761",
"telephone_number": "541-553-2134",
"fax_number": "541-553-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 KOTNUM ROAD",
"city": "WARM SPRINGS",
"state": "OR",
"postal_code": "97761",
"telephone_number": "541-553-2134",
"fax_number": "541-553-2481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "MITZIE",
"middle_name": "ALTHEA",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MA",
"license": "22933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139290",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warm Springs, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.