Individual provider Active NPI

Dawn Marie Johnson, PHARM D

  • Pharmacist
  • Gresham, OR
National Provider Identifier
1942500038
Registry record updated Oct 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10502 Issued in OR
Practice address
1001 SW Highland Dr
Gresham, OR 97080-6354
Phone
(503) 667-9305
Fax
(503) 661-6240
NPI assigned
Oct 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10502 OR Primary

Addresses

Primary practice location

1001 SW Highland Dr
Gresham, OR 97080-6354

Mailing address

1001 SW Highland Dr
Gresham, OR 97080-6354
Phone (503) 667-9305

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
10502ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1287878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287878400000",
    "number": "1942500038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SW HIGHLAND DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806354",
            "telephone_number": "503-667-9305",
            "fax_number": "503-661-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SW HIGHLAND DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806354",
            "telephone_number": "503-667-9305",
            "fax_number": "503-661-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-24",
        "last_updated": "2010-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "10502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2010; 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.