NPIMap

Organization Active NPI

Multnomah County

  • Pharmacy
  • Portland, OR
National Provider Identifier
1528073319
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RP-0000961-CS Issued in OR
Legal business name
MULTNOMAH COUNTY
Practice address
5329 NE Martin L King FL Jrblvd2
Portland, OR 97211-3237
Phone
(503) 988-3634
Fax
(503) 988-4345
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Michele Koder
Title
Pharmacy Director
Phone
(503) 988-7278

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RP-0000961-CS OR Primary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

5329 NE Martin L King FL Jrblvd2
Portland, OR 97211-3237

Mailing address

619 NW 6TH Ave FL 7
Portland, OR 97209-3964
Phone (503) 988-3634

Other identifiers 2

IdentifierTypeStateIssuer
2078364OtherPK
136424MedicaidOR

Other names 1

  • NORTHEAST HEALTH CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Multnomah County Health Dept-Pharmacy Admin89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5329 NE Martin L King Jr Blvd
#2
Portland, OR 97211
Phone (503) 988-3634

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1528073319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-3634",
            "fax_number": "503-988-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 NE MARTIN L KING FL JRBLVD2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113237",
            "telephone_number": "503-988-3634",
            "fax_number": "503-988-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTNOMAH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "KODER",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "503-988-7278"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "RP-0000961-CS",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2078364",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136424",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST HEALTH CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTHEAST HEALTH CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 8, 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.