Active NPI
Lecia Marion Van Valkenburg
- Pharmacist
- Tigard, OR
National Provider Identifier
1639302201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 183500000X
- Practice address
- 12240 SW Scholls Ferry Rd
Tigard, OR 97223-3354 - Phone
- (503) 590-7346
- Fax
- (503) 590-2584
- NPI assigned
- Aug 31, 2009
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 183500000X | OR | Primary |
Addresses
Primary practice location
12240 SW Scholls Ferry Rd
Tigard, OR 97223-3354
Mailing address
12240 SW Scholls Ferry Rd
Tigard, OR 97223-3354
Phone (503) 590-7346
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 183500000X | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1639302201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12240 SW SCHOLLS FERRY RD",
"city": "TIGARD",
"state": "OR",
"postal_code": "972233354",
"telephone_number": "503-590-7346",
"fax_number": "503-590-2584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12240 SW SCHOLLS FERRY RD",
"city": "TIGARD",
"state": "OR",
"postal_code": "972233354",
"telephone_number": "503-590-7346",
"fax_number": "503-590-2584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN VALKENBURG",
"first_name": "LECIA",
"middle_name": "MARION",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-31",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "183500000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.