Individual provider Active NPI

Linda Jeanne Millenbach, RPH

  • Pharmacist
  • Portland, OR
National Provider Identifier
1619176229
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP00004744 Issued in NM
Practice address
8867 SE 13TH Ave
Portland, OR 97202-7111
Phone
(503) 239-1134
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00004744 NM Primary

Addresses

Primary practice location

8867 SE 13TH Ave
Portland, OR 97202-7111

Mailing address

8867 SE 13TH Ave
Portland, OR 97202-7111
Phone (503) 239-1134

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP00004744NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1619176229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8867 SE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027111",
            "telephone_number": "503-239-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8867 SE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027111",
            "telephone_number": "503-239-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLENBACH",
        "first_name": "LINDA",
        "middle_name": "JEANNE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00004744",
            "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 Jul 13, 2007; 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.