KELSEY WALLACE (NPI# 1508098914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508098914 |
| Entity Type | Individual |
| Full Name | KELSEY WALLACE |
| Credential | PHARMD |
| Practice Address |
522 Nw 24th Cir Camas WA 98607 |
| Mailing Address |
2335 Nw Raleigh St Unit 421 Portland OR 97210-3731 |
| Practice Telephone | 3609046581 |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2019-05-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH-0011606 | OR | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 00070414 | WA | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0011606 | OR | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13221 Sw 68th Pkwy Ste 200, Tigard, OR 972238328 | 5032135536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285199083 | Kelsey Ann Wallace | Specialist/Technologist | 3362 Fox Creek Ln, Sharpsville, PA 16150-9330 | 2019-02-05 |
| 1063870418 | Kelsey Wallace | Massage Therapist | 437 Fern Ave, #d, Jackson, MI 49202-3970 | 2016-02-01 |
| 1013576990 | Kelsey A Wallace | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2019-06-13 |
| 1023328051 | Kelsey Marie Wallace | Counselor | 3115 Douglas Ave, Des Moines, IA 50310-5307 | 2010-10-08 |
| Street Address |
522 NW 24TH CIR |
| City | CAMAS |
| State | WA |
| Zip Code | 98607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952832651 | An Nguyen | Family Medicine | 4500 Se Columbia Palisades Drive, Camas, WA 98607 | 2017-03-23 |
| 1861935454 | Amanda Anstead | Case Manager/Care Coordinator | 329 Lechner Street, Camas, WA 98607 | 2016-11-30 |
| 1841697604 | Samantha Christine Cunningham | Counselor | 3400 Se 196th Ave., Ste 102, Camas, WA 98607 | 2014-11-21 |
| 1588075188 | Luiza Vasiliu Pollock | Counselor | 3400 Se 196th Ave, Suite 102, Camas, WA 98607 | 2014-05-16 |
| 1801147277 | Nichol Marie Danielson | Massage Therapist | 1905 Se 192nd Ave., Suite 111, Camas, WA 98607 | 2012-09-26 |
| 1194074781 | Natasha Nicole Portman | Interpreter | 3003 Ne 3rd Ave, #210, Camas, WA 98607 | 2012-08-29 |
| 1306119334 | Jeannie Kay | Hearing Instrument Specialist | 19610 Se 1st Street, Hearing Center, Camas, WA 98607 | 2012-02-22 |
| 1447581962 | Summer Nichole Dowell | Massage Therapist | 211 Ne 4th Avenue, Camas, WA 98607 | 2010-01-22 |
| 1891954111 | Sarah Sue Louise Winslow | Family Medicine | 315 Ne 192nd Ave, Suite 310, Camas, WA 98607 | 2008-06-02 |
| 1811155773 | Raghuram B Bhat | Psychiatry & Neurology | 417 Ne 2nd Ave Ste 205, Camas, WA 98607 | 2008-05-28 |
| Find all providers in zip 98607 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356889075 | Jennifer Rhodes | Pharmacist | 1418 Ne 249th Ave, Camas, WA 98607-9730 | 2017-02-01 |
| 1134486103 | Ryan Erlewine | Pharmacist | 3210 Nw Grass Valley Dr, Camas, WA 98607-4001 | 2012-04-16 |
| 1689998411 | Tara L Pfund | Pharmacist | 1027 Nw Goodwin St, Camas, WA 98607-8750 | 2010-03-23 |
| 1528278645 | Jan Chow | Pharmacist | 1518 Nw 43rd Cir, Camas, WA 98607-8595 | 2007-05-24 |
| 1528671591 | Tho Thien Ai Duc Dinh | Pharmacist | 3328 Ne 3rd Ave, Camas, WA 98607-2436 | 2020-08-28 |
| 1922527902 | Zheng Sheng Peh | Pharmacist | 3328 Ne 3rd Ave, Camas, WA 98607-2436 | 2017-09-12 |
| 1184172447 | Riham Girgis | Pharmacist | 3328 Ne 3rd Ave, Camas, WA 98607-2436 | 2016-09-15 |
| 1447535505 | Amy Lynn Holden | Pharmacist | 3328 Ne 3rd Ave, Camas, WA 98607-2436 | 2011-10-19 |
| 1437431475 | Brian Presley | Pharmacist | 19610 Se 1st St, Camas, WA 98607-7472 | 2011-09-15 |
| 1003102765 | Jason Shimata | Pharmacist | 19610 Se 1st St, Camas, WA 98607-7472 | 2011-06-21 |
| Find all providers in CAMAS | ||||
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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.