Individual provider Active NPI

Elizah A Owens, RPH

  • Pharmacist
  • Portland, OR
National Provider Identifier
1912208331
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9405 Issued in OR
Practice address
3930 SE Powell Blvd
Portland, OR 97202-1722
Phone
(503) 772-4445
Fax
(503) 772-4448
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9405 OR Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0009045 OR

Addresses

Primary practice location

3930 SE Powell Blvd
Portland, OR 97202-1722

Mailing address

3930 SE Powell Blvd
Portland, OR 97202-1722
Phone (503) 772-4445

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9405ORMDPharmacist
0009045ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1912208331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021722",
            "telephone_number": "503-772-4445",
            "fax_number": "503-772-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021722",
            "telephone_number": "503-772-4445",
            "fax_number": "503-772-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ELIZAH",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "9405",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0009045",
            "primary": false
        }
    ],
    "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 Dec 17, 2015; 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.