Sean P Phothiyane, PHARM.D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH10851 Issued in OR

Practice address

198 NE Combs Flat Rd Ste 100
Prineville, OR 97754-2563

Phone

(541) 447-4111

Fax

(541) 416-9570

NPI assigned

Sep 16, 2009

Last updated

Sep 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Home Town Drugs of Prineville Inc

  dba Clinic Pharmacy

  • Community/Retail Pharmacy
  • Prineville, OR
  • NPI 1801924006
  NPD
• Walgreen Co

  dba Walgreens #09287

  • Pharmacy
  • Salem, OR
  • NPI 1396799540
  NPD (past)

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1700119120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 NE COMBS FLAT RD STE 100",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977542563",
            "telephone_number": "541-447-4111",
            "fax_number": "541-416-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 NE COMBS FLAT RD STE 100",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977542563",
            "telephone_number": "541-447-4111",
            "fax_number": "541-416-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOTHIYANE",
        "first_name": "SEAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-16",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH10851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Perrin, RN
• Carmen Peters
• James G Petersen, DMD,P.C.
• Traci Lynn Peterson
• Karen Lee Phillips
• Joselene Piedra Rodriguez, DMD
• Elizabeth Kristen Pifer
• Shelissia Marie Pincenti
• Ogilvia Pineda, CADC I
• Pioneer Memorial Hospital

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Prineville, OR
• Providers in Prineville, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.