Active NPI
Tonia Ann Jacobs
- Pharmacy Technician
- Beaverton, OR
National Provider Identifier
1639442106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- CPT-0002261
- Practice address
- 4750 SW Western Ave
Beaverton, OR 97005-3431 - Phone
- (503) 626-4710
- NPI assigned
- Feb 14, 2012
- Last updated
- Feb 14, 2012
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | CPT-0002261 | OR | Primary |
Addresses
Primary practice location
4750 SW Western Ave
Beaverton, OR 97005-3431
Mailing address
4750 SW Western Ave
Beaverton, OR 97005-3431
Phone (503) 626-4710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPT-0002261 | Other | OR | STATE TECHNICIAN LICENSE |
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 |
|---|---|---|---|
| CPT-0002261 | OR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329177600000",
"number": "1639442106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053431",
"telephone_number": "503-626-4710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4750 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053431",
"telephone_number": "503-626-4710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "TONIA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-14",
"last_updated": "2012-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "OR",
"license": "CPT-0002261",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE TECHNICIAN LICENSE",
"identifier": "CPT-0002261",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.