Active NPI
Tracee Elizabeth Mock, PHARMD
- Pharmacist
- Newberg, OR
National Provider Identifier
1861114043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0019045
- Practice address
- 1001 N Providence Dr
Newberg, OR 97132-7485 - Phone
- (503) 537-1555
- NPI assigned
- Sep 14, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0019045 | OR | Primary |
Addresses
Primary practice location
1001 N Providence Dr
Newberg, OR 97132-7485
Mailing address
3826 SE Belle Oak Ave
Hillsboro, OR 97123-9214
Phone (503) 207-8058
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0019045 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1861114043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3826 SE BELLE OAK AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971239214",
"telephone_number": "503-207-8058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N PROVIDENCE DR",
"city": "NEWBERG",
"state": "OR",
"postal_code": "971327485",
"telephone_number": "503-537-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOCK",
"first_name": "TRACEE",
"middle_name": "ELIZABETH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0019045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newberg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.