Active NPI
Shaun C Dillon, R.PH.
- Pharmacist
- Portland, OR
National Provider Identifier
1669730594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0009307
- Practice address
- 13 NW 23Rd PL
Portland, OR 97210-3534 - Phone
- (503) 226-6211
- Fax
- (503) 226-5390
- NPI assigned
- Apr 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH-0009307 | OR | |
| Pharmacist | 183500000X | RPH-0009307 | OR | Primary |
Addresses
Primary practice location
13 NW 23Rd PL
Portland, OR 97210-3534
Mailing address
430 SE 192ND Ave
Vancouver, WA 98683-9531
Phone (503) 349-6644
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0009307 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Interoperability endpoints
- sdillon844326@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1669730594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 SE 192ND AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839531",
"telephone_number": "503-349-6644",
"fax_number": "888-452-8127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 NW 23RD PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972103534",
"telephone_number": "503-226-6211",
"fax_number": "503-226-5390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "SHAUN",
"middle_name": "C",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-28",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "RPH-0009307",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0009307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.