Mountain Park Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1270 Issued in OR

Legal business name

MOUNTAIN PARK PHARMACY

Practice address

3 Monroe Pkwy Ste O
Lake Oswego, OR 97035-8874

Phone

(503) 636-1243

Fax

(503) 636-0925

NPI assigned

Mar 17, 2007

Organization subpart

No

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

Authorized official

Name

Julie Bleakman, RPH

Title

Owner

Phone

(503) 636-1243

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669596508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MONROE PKWY STE O",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358874",
            "telephone_number": "503-636-1243",
            "fax_number": "503-636-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MONROE PKWY STE O",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358874",
            "telephone_number": "503-636-1243",
            "fax_number": "503-636-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN PARK PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLEAKMAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-636-1243",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "1270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052113",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ligia Ines Morrison, D.D.S
• Patrick Morrissey, DDS
• Diane Moskowitz, M.A.
• Evangelina Mosqueda
• Pardise Mossalman
• Mountain Peak Counseling, LLC
• Kenzie Mozejko
• Mt Hood General and Vascular Surgeons LLC
• Christina M Mueller, L.M.T.
• Stacey Mueller, BS, RDH

• Community/Retail Pharmacy in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.