Active NPI
Dominic Karr Chan, PHARMD
- Pharmacist
- Portland, OR
National Provider Identifier
1629599477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14802
- Practice address
- 2801 N Gantenbein Ave
Portland, OR 97227-1623 - Phone
- (503) 413-1757
- NPI assigned
- Jul 2, 2017
- Last updated
- Jul 2, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63293 | CA | |
| Pharmacist | 183500000X | 14802 | OR | Primary |
Addresses
Primary practice location
2801 N Gantenbein Ave
Portland, OR 97227-1623
Mailing address
3970 N Interstate Ave Unit 310
Portland, OR 97227-1084
Phone (626) 757-3617
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 |
|---|---|---|---|
| 63293 | CA | MD | Pharmacist |
| 14802 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498953600000",
"number": "1629599477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3970 N INTERSTATE AVE UNIT 310",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271084",
"telephone_number": "626-757-3617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-413-1757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "DOMINIC",
"middle_name": "KARR",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-02",
"last_updated": "2017-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63293",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "14802",
"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 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.