Active NPI
Cynthia Louise Goller, CPTH
- Other Technician
- Pendleton, OR
National Provider Identifier
1811261688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- CPT-0000608
- Practice address
- 901 SW Emigrant Ave
Pendleton, OR 97801-1948 - Phone
- (541) 276-7909
- Fax
- (541) 276-2101
- NPI assigned
- Feb 27, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | CPT-0000608 | OR | Primary |
Addresses
Primary practice location
901 SW Emigrant Ave
Pendleton, OR 97801-1948
Mailing address
901 SE Emigrant Ave.
Pendleton, OR 97801
Phone (541) 276-7909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPT-0000608 | Other | OR | STATE PHARMACIST LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPT-0000608 | OR | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1811261688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 SE EMIGRANT AVE.",
"city": "PENDLETON",
"state": "OR",
"postal_code": "97801",
"telephone_number": "541-276-7909",
"fax_number": "541-276-2101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 SW EMIGRANT AVE",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978011948",
"telephone_number": "541-276-7909",
"fax_number": "541-276-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLLER",
"first_name": "CYNTHIA",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"credential": "CPTH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-27",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "OR",
"license": "CPT-0000608",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LICENSE",
"identifier": "CPT-0000608",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.