Willamette Compounding Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

2122 Issued in OR

Legal business name

WILLAMETTE COMPOUNDING PHARMACY

Practice address

150 Liberty St SE
Salem, OR 97301-3506

Phone

(504) 364-3336

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Dwight Quisenberry, RPH

Title

President

Phone

(503) 364-3336

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1750554622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013506",
            "telephone_number": "504-364-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013506",
            "telephone_number": "504-364-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "QUISENBERRY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DWIGHT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-364-3336",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "OR",
            "license": "2122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Wilhelm, LCSW
• Mark Allen Wilhite, MHA1
• Amber Wilkinson-Polomsky
• Emily Anne Wilkinson, MD
• Claudia Will, R.N.
• Willamette Dental Group
• Willamette Ear Nose & Throat LLP
• Willamette Education Service District
• Willamette Education Service District
• Willamette Education Service District

• Compounding Pharmacy in Salem, OR
• Providers in Salem, OR by specialty
• Compounding Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.