Active NPI
Yisak Mesfin Gessese, PHARMA.D
- Pharmacist
- Portland, OR
National Provider Identifier
1891447322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10720
- Practice address
- 11019 SE Brooklyn CT
Portland, OR 97266-1585 - Phone
- (202) 989-8659
- NPI assigned
- Jan 26, 2022
- Sex
- Male
- 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 | 10720 | OR | Primary |
Addresses
Primary practice location
11019 SE Brooklyn CT
Portland, OR 97266-1585
Mailing address
11019 SE Brooklyn CT
Portland, OR 97266-1585
Phone (202) 989-8659
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10720 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643155200000",
"number": "1891447322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11019 SE BROOKLYN CT",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972661585",
"telephone_number": "202-989-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11019 SE BROOKLYN CT",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972661585",
"telephone_number": "202-989-8659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GESSESE",
"first_name": "YISAK",
"middle_name": "MESFIN",
"name_prefix": "Dr.",
"credential": "PHARMA.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-26",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "10720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.