Individual provider Active NPI

Russell A Wendt, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Gresham, OR
National Provider Identifier
1992061048
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH0007549 Issued in OR
Practice address
2497 NE Roberts Ave
Gresham, OR 97080
Phone
(503) 669-4233
Fax
(503) 669-4238
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7549 OR
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH0007549 OR Primary

Addresses

Primary practice location

2497 NE Roberts Ave
Gresham, OR 97080

Mailing address

2497 NE Roberts Ave
Gresham, OR 97080
Phone (503) 669-4233

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
7549ORMDPharmacist
RPH0007549ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1992061048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2497 NE ROBERTS AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97080",
            "telephone_number": "503-669-4233",
            "fax_number": "503-669-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2497 NE ROBERTS AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97080",
            "telephone_number": "503-669-4233",
            "fax_number": "503-669-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "RUSSELL",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "7549",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH0007549",
            "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 May 4, 2017; 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.