DR. GABRIEL TUCKER BERTELL (NPI# 1467725432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467725432 |
| Entity Type | Individual |
| Full Name | DR. GABRIEL TUCKER BERTELL |
| Credential | PHARMD |
| Practice Address |
2497 Se Burnside Rd Gresham OR 97080-1246 |
| Mailing Address |
2497 Ne Burnside Rd Gresham OR 97080 |
| Practice Telephone | 5036694233 |
| Mailing Telephone | 5036694233 |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2017-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH-0011399 | OR | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0011399 | OR | Pharmacy Service Providers |
| Street Address |
2497 SE BURNSIDE RD |
| City | GRESHAM |
| State | OR |
| Zip Code | 97080-1246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457396525 | Fred Meyer Stores Inc | Pharmacy | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2006-06-20 |
| 1790186450 | Melina Wheeler | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2014-09-11 |
| 1134559487 | Kim Sato | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2013-11-24 |
| 1508292764 | Sean Harry Finn | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2013-09-19 |
| 1326384900 | Yolanda Tiu Santiago | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2012-12-29 |
| 1891052700 | Amanda Ruth Norman | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2012-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528428554 | Jeffrey Henry Lucero | Social Worker | 4687 Se 1st Terrace, Gresham, OR 97080 | 2016-03-03 |
| 1124371059 | Nickole Turner | Massage Therapist | 2831 Se Palmquist Rd #157, Gresham, OR 97080 | 2012-10-16 |
| 1992061048 | Russell A Wendt | Pharmacist | 2497 Ne Roberts Ave, Gresham, OR 97080 | 2012-04-03 |
| 1821385584 | Angela West | Counselor | 320 Sw 6th Ave., Gresham, OR 97080 | 2011-07-01 |
| 1043543572 | Natalie Dawn Wilson | Behavioral Analyst | 97 Sw Riverview Place, Gresham, OR 97080 | 2009-09-16 |
| 1427205442 | Maria G Jolley | Dental Hygienist | 1267 Se Stapleton Loop, Gresham, OR 97080 | 2008-08-21 |
| 1073776738 | Sabrina Joye Hindman | Marriage & Family Therapist | 6370 Se 26th St, Gresham, OR 97080 | 2008-07-03 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1932223880 | Julie Elizabeth Croshaw | Pharmacist | 2444 E Powell Blvd, Gresham, OR 97080 | 2007-03-18 |
| 1508903261 | Lonetta Elise Davis | Adult Companion | 349 Se Plamblad, Gresham, OR 97080 | 2007-01-31 |
| Find all providers in zip 97080 | ||||
| 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 |
|---|---|---|---|---|
| 1982016416 | Marcos Edmundo Lobato-arroyo | Pharmacist | 24800 Se Stark St, Gresham, OR 97030-3378 | 2014-06-02 |
| 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.