Alice Mattila, PHARMD

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

121182 Issued in MN

Practice address

10132 W 76TH St
Eden Prairie, MN 55344-3728

Phone

(877) 323-4292

NPI assigned

Apr 30, 2021

Sex

Female

Sole proprietor

Yes

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

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1902489651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 UNION TERRACE LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411523",
            "telephone_number": "612-666-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10132 W 76TH ST",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443728",
            "telephone_number": "877-323-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTILA",
        "first_name": "ALICE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MN",
            "license": "121182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zen Matsuda, D.C.
• Giselle Mary Matsui, M.A.
• Matthew J Alvord DC LTD
• Matthew Meyer D.D.S., P.a.
• Vickie Lynn Matthias Hagen, M.S., C.G.C.
• Amy Mattson
• Kyle Maurer, DO
• Susan May, MA, LP
• John Robert Mbagwu, PHARM.D.
• Caleb McBee

• Pharmacotherapy Pharmacist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Pharmacotherapy Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.