NPIMap

Individual provider Active NPI

Jennifer L Tatterson, PHARM.D

  • Pharmacist
  • Portland, OR
National Provider Identifier
1811205354
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0011507 Issued in OR
Practice address
940 SE Cesar E Chavez Blvd
Portland, OR 97214-4316
Phone
(503) 238-6053
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0011507 OR Primary
Pharmacist 183500000X 13676-40 WI

Addresses

Primary practice location

940 SE Cesar E Chavez Blvd
Portland, OR 97214-4316

Mailing address

940 SE Cesar E Chavez Blvd
Portland, OR 97214-4316
Phone (503) 238-6053

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

LicenseStateTypeSpecialty
RPH-0011507ORMDPharmacist
13676-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1811205354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144316",
            "telephone_number": "503-238-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144316",
            "telephone_number": "503-238-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATTERSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0011507",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13676-40",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.