Individual provider Active NPI

Kasem Darwish El-Hajji, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Coos Bay, OR
National Provider Identifier
1639789266
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH-0018357 Issued in OR
Practice address
630 Miluk Dr
Coos Bay, OR 97420-7728
Phone
(541) 435-7039
Fax
(541) 982-5352
NPI assigned
Aug 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS61027 FL
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH-0018357 OR Primary

Addresses

Primary practice location

630 Miluk Dr
Coos Bay, OR 97420-7728

Mailing address

PO Box 3190
Coos Bay, OR 97420-0407
Phone (541) 435-7039

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

LicenseStateTypeSpecialty
PS61027FLMDPharmacist
RPH-0018357ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Interoperability endpoints

  • Direct secure messaging: kasem.elhajji.p2@direct.coquilletribe.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1639789266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3190",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200407",
            "telephone_number": "541-435-7039",
            "fax_number": "541-982-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MILUK DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207728",
            "telephone_number": "541-435-7039",
            "fax_number": "541-982-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-HAJJI",
        "first_name": "KASEM",
        "middle_name": "DARWISH",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS61027",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0018357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.