Peter David Kollman, RPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

6849 Issued in OR

Practice address

13130 SE 84TH Ave
Clackamas, OR 97015-9733

Phone

(503) 794-5520

Fax

(503) 794-5528

NPI assigned

Nov 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1881971638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13130 SE 84TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159733",
            "telephone_number": "503-794-5520",
            "fax_number": "503-794-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13130 SE 84TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159733",
            "telephone_number": "503-794-5520",
            "fax_number": "503-794-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLMAN",
        "first_name": "PETER",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "6849",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "6849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Yj Ko, PA-C
• Susan Elise Koch, M.D.
• Lillie Ann Koehler, DPT
• Chika Koida
• Natalya Y Kolesnikova, RRT
• Amanda Marie Komar, M.S., PA-C
• Eric Steven Komar, PA-C
• Ute Kongsbak
• James Michael Konieczny, D.P.M.
• Alexander Michael Kositch, M.D.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.