Mikaela Jade Anderson, PHARMD, RPH, MBA

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH-0017449 Issued in OR

Practice address

2600 Center St NE
Salem, OR 97301-2669

Phone

(503) 947-8086

NPI assigned

Sep 25, 2019

Last updated

Sep 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Doctor of Pharmacy, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1851942353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4764 LIBERTY RD S APT 331",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025294",
            "telephone_number": "503-941-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012669",
            "telephone_number": "503-947-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MIKAELA",
        "middle_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0017449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Nelson Anderson, MS, CCC-SLP
• Gwenellyn Anderson, ED.D.
• Justin Alton Anderson, DDS
• Kellie Anderson, CDA, EFDA
• Kelsey Jane Anderson
• Neva Anderson
• Peter William Anderson, DC, PA-C
• Rebecca Anderson
• Robert Anderson
• Samantha Anderson

• Pharmacist in Salem, OR
• Providers in Salem, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.