Active NPI
Patrick Juba, RPH
- Pharmacist
- Clackamas, OR
National Provider Identifier
1750030771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0018546
- Practice address
- 9000 SE Sunnyside Rd
Clackamas, OR 97015-9758 - Phone
- (503) 974-5058
- NPI assigned
- Mar 18, 2022
- Last updated
- Mar 18, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0018546 | OR | Primary |
Addresses
Primary practice location
9000 SE Sunnyside Rd
Clackamas, OR 97015-9758
Mailing address
9761 SE 49TH Ave
Milwaukie, OR 97222-5115
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-0018546 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647561600000",
"number": "1750030771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9761 SE 49TH AVE",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972225115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159758",
"telephone_number": "503-974-5058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUBA",
"first_name": "PATRICK",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-18",
"last_updated": "2022-03-18",
"certification_date": "2022-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0018546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.