Active NPI
Tresa Marie Mokalla, RPH
- Pharmacist
- Clackamas, OR
National Provider Identifier
1790021574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7927
- Practice address
- 16301 SE 82ND Dr
Clackamas, OR 97015-9598 - Phone
- (503) 657-1575
- NPI assigned
- Dec 23, 2012
- Sex
- Female
- 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 | 7927 | OR | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 7927 | OR |
Addresses
Primary practice location
16301 SE 82ND Dr
Clackamas, OR 97015-9598
Mailing address
16301 SE 82ND Dr
Clackamas, OR 97015-9598
Phone (503) 657-1575
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 |
|---|---|---|---|
| 7927 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493164800000",
"number": "1790021574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16301 SE 82ND DR",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159598",
"telephone_number": "503-657-1575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16301 SE 82ND DR",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159598",
"telephone_number": "503-657-1575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOKALLA",
"first_name": "TRESA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-23",
"last_updated": "2017-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "7927",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "7927",
"primary": false
}
],
"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 Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.