DUSTIN J CLARK (NPI# 1235757915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235757915 |
| Entity Type | Individual |
| Full Name | DUSTIN J CLARK |
| Credential | PHARMD |
| Practice Address |
4400 Ne Halsey St Ste 490 Portland OR 97213-1545 |
| Mailing Address |
8423 Sw Pointer Way Apt M Portland OR 97225-7316 |
| Practice Telephone | 5038936900 |
| Practice Fax Number | 5034873595 |
| Mailing Telephone | 5413015735 |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
RPH-0017464 | OR | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700421328 | Dustin Ryan Clark | Case Manager/Care Coordinator | 735 North Dr, Hopkinsville, KY 42240-2620 | 2019-11-07 |
| 1225449671 | Dustin J Clark | Chiropractor | 601 S Race St, Port Angeles, WA 98362-6400 | 2014-05-19 |
| 1285831644 | Dustin Michael Clark | Emergency Medicine | 1420 Tusculum Blvd, Laughlin Memorial Hospital, Greeneville, TN 37745 | 2007-06-29 |
| 1265562185 | Dustin E Clark | Driver | 128 Scenega, Valdez, AK 99686 | 2007-03-07 |
| Street Address |
4400 NE HALSEY ST STE 490 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-1545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255544631 | Kristina Lee Butler | Pharmacist | 4400 Ne Halsey St Ste 490, Portland, OR 97213-1545 | 2007-05-08 |
| 1851915979 | Adam D Olesen | Pharmacist | 4400 Ne Halsey St Ste 490, Portland, OR 97213-1545 | 2020-06-04 |
| 1619494879 | Justin Bachman | Pharmacist | 4400 Ne Halsey St Ste 490, Portland, OR 97213-1545 | 2017-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265977086 | Robert Martini | Pharmacist | 18815 Ne Clackamas St, Portland, OR 97230-7138 | 2017-01-03 |
| 1477901643 | Shellie Weatherspoon | Pharmacist | 1040 Nw 22nd Ave Ste 100, Portland, OR 97210-3036 | 2016-05-29 |
| 1518585199 | Kasey Rubin | Pharmacist | 4400 Ne Halsey St Bldg 2, Portland, OR 97213-1545 | 2020-07-09 |
| 1194377960 | Anne M Thibodeaux | Pharmacist | 4400 Ne Halsey St, Portland, OR 97213-1545 | 2019-07-11 |
| 1720645872 | Kirsten Kadoyama | Pharmacist | 3600 N Interstate Ave, Portland, OR 97227 | 2019-05-23 |
| 1508422486 | Adam Rory Saulles | Pharmacist | 6348 Ne Halsey St, Portland, OR 97213-4720 | 2019-05-15 |
| 1295297018 | Victor Tran | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-04-01 |
| 1679058564 | Rita Maria Parsiani | Pharmacist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2018-09-26 |
| 1598245151 | Kelsey Hawkins | Pharmacist | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2018-08-14 |
| 1952805939 | Allyson Dolence | Pharmacist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2018-03-22 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.