PNW Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

PNW PHARMACY LLC

Practice address

400 NE 7TH St
Gresham, OR 97030-5604

Phone

(503) 573-3278

Fax

(503) 573-3270

NPI assigned

Mar 15, 2024

Organization subpart

No

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

Authorized official

Name

Kevin Michael Ricker

Title

Managing Member

Phone

(503) 887-7395

Specialties & licenses 2

Addresses

Other names 2

• PNW RX Doing business as
• Propac Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1710746458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NE 7TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305604",
            "telephone_number": "503-573-3278",
            "fax_number": "503-573-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE 7TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305604",
            "telephone_number": "503-573-3278",
            "fax_number": "503-573-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNW PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-887-7395"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNW RX",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Propac Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Monique Pixley
• Malis Pizana
• Lesley Yadira Plata Valenzuela, MSW
• Pleasant Valley RTH LLC
• Craig Plummer, PT
• Paul Podett, M.D.
• Joshua Lewis Poitra, CRM/PSS
• Shawna Pool, LMT
• Damaris Abigail Pop, PA
• Emelia Madeleine Portuondo, N.D.

• Long Term Care Pharmacy in Gresham, OR
• Providers in Gresham, OR by specialty
• Long Term Care Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.