Active NPI
Carly Gostanian
- Pharmacy
- Keizer, OR
National Provider Identifier
1740776319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PI-0012993
- Practice address
- 3862 River Rd N
Keizer, OR 97303-4866 - Phone
- (503) 371-6717
- NPI assigned
- Jul 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PI-0012993 | OR | Primary |
Addresses
Primary practice location
3862 River Rd N
Keizer, OR 97303-4866
Mailing address
4010 NW Witham Hill Dr Apt 123
Corvallis, OR 97330-1648
Phone (559) 280-4063
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PI-0012993 | OR | MD | Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530921600000",
"number": "1740776319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 NW WITHAM HILL DR APT 123",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973301648",
"telephone_number": "559-280-4063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3862 RIVER RD N",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034866",
"telephone_number": "503-371-6717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSTANIAN",
"first_name": "CARLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-07",
"last_updated": "2018-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OR",
"license": "PI-0012993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.