Individual provider Active NPI

Ekdara Sin, PHARM.D.

  • Pharmacist
  • Tigard, OR
National Provider Identifier
1841660461
Registry record updated Sep 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0014964 Issued in OR
Practice address
11863 SW Greenburg Rd Apt 5
Tigard, OR 97223-6493
Phone
(541) 281-9070
NPI assigned
Sep 26, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0014964 OR Primary

Addresses

Primary practice location

11863 SW Greenburg Rd Apt 5
Tigard, OR 97223-6493

Mailing address

11863 SW Greenburg Rd Apt 5
Tigard, OR 97223-6493
Phone (541) 281-9070

Other identifiers 1

IdentifierTypeStateIssuer
RPH-0014964OtherORPHARMACY 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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH-0014964ORMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443225600000",
    "number": "1841660461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11863 SW GREENBURG RD APT 5",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236493",
            "telephone_number": "541-281-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11863 SW GREENBURG RD APT 5",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236493",
            "telephone_number": "541-281-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIN",
        "first_name": "EKDARA",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-26",
        "last_updated": "2015-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "RPH-0014964",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2015; 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.