NPIMap

Organization Active NPI

Oregon Health & Science University

Doing business as Ohsu Gabriel Park Pharmacy

  • Community/Retail Pharmacy
  • Portland, OR
National Provider Identifier
1982797155
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
OREGON HEALTH & SCIENCE UNIVERSITY
Doing business as
Ohsu Gabriel Park Pharmacy
Practice address
4411 SW Vermont St
Portland, OR 97219-1020
Phone
(503) 494-2098
Fax
(503) 494-2255
NPI assigned
Oct 2, 2006
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Kelly Anne Smith
Title
Vice President, Erc
Phone
(503) 494-4817

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X NU Primary
Institutional Pharmacy 3336I0012X RP0002250CS OR

Addresses

Primary practice location

4411 SW Vermont St
Portland, OR 97219-1020

Mailing address

3181 SW Sam Jackson Park Rd
Mail Code: CR9-4 Pharmacy Compliance
Portland, OR 97239-3011
Phone (503) 494-8007

Other identifiers 5

IdentifierTypeStateIssuer
242116MedicaidOR
PH027ORMedicaidAK
1982797155MedicaidID
1046485MedicaidWA
3842083OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • OHSU GABRIEL PARK PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930100479 OR DME Supplier - Pharmacy 4284542945 Practice locations: Portland, OR
O20181127001493 OR Part B Supplier - Mass Immunization (Roster Biller Only) 4284542945 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Hillsboro, OR; Beaverton, OR

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Gabriel Park Pharmacy4411 SW Vermont St, Portland, OR 97219-1020(503) 494-2098 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jul 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Oregon Health Sciences University26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ohsu Hospitals and ClinicsPortland, OR, CCN 380009 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1995
Hillsboro Medical CenterHillsboro, OR, CCN 380021 Hospital Operational/Managerial Control Feb 1, 2016
Tuality HealthcareHillsboro, OR, CCN 38S021 Hospital Operational/Managerial Control Feb 1, 2016
Ohsu Family Medicine at RichmondPortland, OR, CCN 381884 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1995
Jul 1, 1995
Richmond Immediate CarePortland, OR, CCN 381938 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 10, 2013
Jun 10, 2013
Ohsu Health Family Medicine, East Portland Community Health CenterPortland, OR, CCN 381028 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 15, 2024
Feb 15, 2024
Ohsu Family Medicine at ScappooseScappoose, OR, CCN 383849 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1995
Jul 1, 1995

Owned or controlled facilities with NPI records 17

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1982797155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE: CR9-4 PHARMACY COMPLIANCE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8007",
            "fax_number": "503-494-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191020",
            "telephone_number": "503-494-2098",
            "fax_number": "503-494-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON HEALTH & SCIENCE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT, ERC",
        "authorized_official_telephone_number": "503-494-4817"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "OR",
            "license": "RP0002250CS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242116",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH027OR",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982797155",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1046485",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3842083",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OHSU GABRIEL PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OHSU GABRIEL PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.