Active NPI
Theresa Moeller, RPH
- Pharmacist
- Vancouver, WA
National Provider Identifier
1831495142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00017688
- Practice address
- 13009 NE Highway 99
Vancouver, WA 98686-2741 - Phone
- (360) 574-0914
- NPI assigned
- Feb 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00017688 | WA | Primary |
Addresses
Primary practice location
13009 NE Highway 99
Vancouver, WA 98686-2741
Mailing address
302 Hillshire Dr
Woodland, WA 98674-9339
Phone (360) 841-8160
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 |
|---|---|---|---|
| PH00017688 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Hi School Pharmacy Inc | 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.
-
- Long Term Care Pharmacy
- Vancouver, WA
- NPI 1871552455
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296691200000",
"number": "1831495142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 HILLSHIRE DR",
"city": "WOODLAND",
"state": "WA",
"postal_code": "986749339",
"telephone_number": "360-841-8160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13009 NE HIGHWAY 99",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986862741",
"telephone_number": "360-574-0914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOELLER",
"first_name": "THERESA",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-03",
"last_updated": "2011-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00017688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.