Kelle Miyama, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH-0018028 Issued in OR

Practice address

5685 Inland Shores Way N
Keizer, OR 97303-3794

Phone

(503) 779-2271

NPI assigned

Jun 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1992373864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 INLAND SHORES WAY N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973033794",
            "telephone_number": "503-779-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 INLAND SHORES WAY N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973033794",
            "telephone_number": "503-779-2271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2725 SW Cedar Hills Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970051435",
            "country_code": "US",
            "telephone_number": "503-352-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIYAMA",
        "first_name": "KELLE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0018028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tracy Jean Moncrief
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• Rochelle Moore
• Teressa S Moore, LMT

• Pharmacist in Keizer, OR
• Providers in Keizer, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.