CAROL A FUNATAKE (NPI# 1386084515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386084515 |
Entity Type | Individual |
Full Name | CAROL A FUNATAKE |
Practice Address |
14700 Se Mcloughlin Blvd Milwaukie OR 97267-1417 |
Practice Telephone | 5036524133 |
Practice Fax Number | 5036524120 |
Mailing Telephone | 5036524133 |
Mailing Fax Number | 5036524120 |
Enumeration Date | 2013-07-02 |
Last Update Date | 2017-05-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 183500000X | Pharmacist | 6280 | OR | Pharmacy Service Providers |
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
6280 | OR | Pharmacy Service Providers |
Street Address |
14700 SE MCLOUGHLIN BLVD |
City | MILWAUKIE |
State | OR |
Zip Code | 97267-1417 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548205610 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 14700 Se Mcloughlin Blvd, Milwaukie, OR 97267-1417 | 2006-06-20 |
1467888909 | Kristen Langit Malabanan | Pharmacist | 14700 Se Mcloughlin Blvd, Milwaukie, OR 97267-1417 | 2013-09-16 |
1992044986 | Jeffrey Jay Graves | Pharmacist | 14700 Se Mcloughlin Blvd, Milwaukie, OR 97267-1417 | 2013-02-11 |
1942549589 | Joseph Caldwell | Pharmacist | 14700 Se Mcloughlin Blvd, Milwaukie, OR 97267-1417 | 2013-02-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851911036 | Michelle Renee Gilham | Massage Therapist | 16560 S.e. 80th Ave, Portland Or 97267, 19650 Se 80th Ave, Portland, OR 97267 | 2020-04-17 |
1629557442 | Benchmark Physical Therapy of Or, LLC | Occupational Therapist | 14874 Se Webster Rd, Milwaukie, OR 97267 | 2018-08-13 |
1326541764 | Theresa Elaine Day | Massage Therapist | 2080 Se Oak Grove Blvd Ste 16, Portland, OR 97267 | 2018-03-12 |
1881015378 | Kathryn Louise Engstrom | Registered Nurse | 6901 Se Lake Road, Portland, OR 97267 | 2013-12-30 |
1285951293 | Eliza Ann Rowley | Acupuncturist | 2080 Se Oak Grove Blvd #9, Milwaukie, OR 97267 | 2010-04-29 |
1346438124 | Rx Direct Inc | Pharmacy | 16246 Se Mcloughlin, Milwaukie, OR 97267 | 2007-10-05 |
1477740827 | Olson Drug, Inc | Durable Medical Equipment & Medical Supplies | 16244 Se Mcloughlin Blvd, Milwaukie, OR 97267 | 2007-10-01 |
1831308451 | Jeannie Marie Baer | Massage Therapist | 16705 Se Mcloughlin, Milwaukie, OR 97267 | 2007-05-21 |
1902923667 | Matthew William Krueger | Specialist/Technologist | 4950 Se Roethe Rd., Milwaukie, OR 97267 | 2007-03-26 |
1316084049 | Renee' Lorena Raschke | Counselor | 17070se Mcloughlin Blvd., Milwaukie, OR 97267 | 2007-01-31 |
Find all providers in zip 97267 |
Taxonomy Code | 1835P0018X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518323187 | Sze Ming Li | Pharmacist | 3300 Se Dwyer Dr, Ste 304, Milwaukie, OR 97222-6548 | 2016-01-12 |
1053690412 | Cynthia Hankins | Pharmacist | 3300 Se Dwyer Dr, Annex Building, Suite #304, Milwaukie, OR 97222-6548 | 2011-08-16 |
1619286390 | Rebecca Elizabeth Black | Pharmacist | 3300 Se Dwyer Dr, Suite 304, Milwaukie, OR 97222-6548 | 2010-09-29 |
1477860559 | Wendy J Eckhart | Pharmacist | 3300 Se Dwyer Dr, Suite 304, Milwaukie, OR 97222-6548 | 2010-09-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194385674 | Joseph Lee Combee | Pharmacist | 4956 Sw Aster St, Corvallis, OR 97333-1367 | 2019-06-17 |
1538627377 | Jacquelyn Jessica Lansing | Pharmacist | 33190 Bloomberg Rd, Eugene, OR 97405-9609 | 2019-03-12 |
1972097699 | Nathan Daniel Hoover | Pharmacist | 1401 North 10th Ave, Stayton, OR 97383 | 2018-06-16 |
1083119994 | Timothy Warren Evans | Pharmacist | 2714 Harbeck Rd, Grants Pass, OR 97527-5630 | 2018-03-24 |
1144737677 | Matthew Ito | Pharmacist | 5805 Sw Delker Rd, Tualatin, OR 97062-7753 | 2018-01-05 |
1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
1336662204 | Jenny French | Pharmacist | 9427 Sw Barnes Rd Ste 295, Portland, OR 97225-6652 | 2017-07-21 |
1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
1841747649 | Richard Bennett | Pharmacist | 425 Burlwood Ave N, Monmouth, OR 97361-2252 | 2016-09-09 |
1316390008 | Timothy L Lichlyter | Pharmacist | 2924 Siskiyou Blvd Ste 102, Medford, OR 97504-8194 | 2016-07-18 |
Find all providers with the same taxonomy |
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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.