Active NPI
Matthew Isiah Gutierrez Respicio, PHARMD
- Pharmacist
- Portland, OR
National Provider Identifier
1770952368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0015015
- Practice address
- 1620 NE Grand Ave
Portland, OR 97232-1149 - Phone
- (503) 493-2715
- NPI assigned
- Sep 24, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0015015 | OR | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH-0015015 | OR |
Addresses
Primary practice location
1620 NE Grand Ave
Portland, OR 97232-1149
Mailing address
1620 NE Grand Ave
Portland, OR 97232-1149
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0015015 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468886400000",
"number": "1770952368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 NE GRAND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 NE GRAND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321149",
"telephone_number": "503-493-2715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESPICIO",
"first_name": "MATTHEW ISIAH",
"middle_name": "GUTIERREZ",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-24",
"last_updated": "2016-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0015015",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "RPH-0015015",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Resonance
- Resonance Counseling and Consultation LLC
- Resonance Natural Medicine LLC
- Resonance Portland (Saren Craig Mental Health and Wellness)
- Resonant Root LLC
- Responsenow Incorporated (ResponseNow Medical Alert Systems)
- Christine Angela Ressler, DMD
- Zoe Ressler
- Restart Counseling and Case Management, LLC
- Restoration Counseling
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.