Individual provider Active NPI

Stacey Olstad, PHARMD

  • Pharmacy
  • Corvallis, OR
National Provider Identifier
1902646938
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
0011402 Issued in OR
Practice address
203 Pharmacy BLDG BLDG 1601SW
Corvallis, OR 97331-8537
Phone
(541) 737-3424
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 0011402 OR Primary

Addresses

Primary practice location

203 Pharmacy BLDG BLDG 1601SW
Corvallis, OR 97331-8537

Mailing address

1975 SE Crystal Lake Dr Unit 112
Corvallis, OR 97333-0005
Phone (541) 231-0241

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

LicenseStateTypeSpecialty
0011402ORMDPharmacy

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1902646938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 SE CRYSTAL LAKE DR UNIT 112",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973330005",
            "telephone_number": "541-231-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 PHARMACY BLDG BLDG 1601SW",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318537",
            "telephone_number": "541-737-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSTAD",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "0011402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.