Individual provider Active NPI

Enrique Perez, PHARM.D

  • Pharmacist
  • Portland, OR
National Provider Identifier
1659091155
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0019140 Issued in OR
Practice address
3527 SE 122ND Ave
Portland, OR 97236-3401
Phone
(503) 760-6688
NPI assigned
Sep 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0019140 OR Primary

Addresses

Primary practice location

3527 SE 122ND Ave
Portland, OR 97236-3401

Mailing address

3527 SE 122ND Ave
Portland, OR 97236-3401

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

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
RPH-0019140ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1659091155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 SE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 SE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363401",
            "telephone_number": "503-760-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ENRIQUE",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0019140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "3527 SE 122nd Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972363401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 2, 2022; 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.