NPIMap

Individual provider Active NPI

Edward Jacobowitz

  • Pharmacist
  • Warrenton, OR
National Provider Identifier
1891493755
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
019336 Issued in OR
Practice address
145 S Highway 101
Warrenton, OR 97146-9314
Phone
(503) 861-1611
NPI assigned
Feb 21, 2023
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 019336 OR Primary

Addresses

Primary practice location

145 S Highway 101
Warrenton, OR 97146-9314

Mailing address

14625 SW Allen Blvd
Beaverton, OR 97007-3697

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

LicenseStateTypeSpecialty
019336ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc PastSince Feb 26, 2023 Accepting new patients
Thrifty Payless Inc PastSince Feb 26, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1891493755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14625 SW ALLEN BLVD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970073697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S HIGHWAY 101",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971469314",
            "telephone_number": "503-861-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBOWITZ",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "019336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.