DR. JENELL LYN HENSON (NPI# 1629084496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629084496 |
Entity Type | Individual |
Full Name | DR. JENELL LYN HENSON |
Credential | PHARMD |
Practice Address |
11565 Sw Pacific Hwy Tigard OR 97223-8845 |
Mailing Address |
17275 Sw Rivendell Dr Portland OR 97224-7626 |
Practice Telephone | 5032937085 |
Mailing Telephone | 5035473143 |
Enumeration Date | 2006-07-31 |
Last Update Date | 2017-04-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 183500000X | Pharmacist | RPH-0011267 | OR | Pharmacy Service Providers |
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0011267 | OR | Pharmacy Service Providers |
Street Address |
11565 SW PACIFIC HWY |
City | TIGARD |
State | OR |
Zip Code | 97223-8845 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063458925 | Fred Meyer Stores Inc | Pharmacy | 11565 Sw Pacific Hwy, Tigard, OR 97223-8845 | 2006-06-21 |
1083081905 | Fred Meyer | Clinic/Center | 11565 Sw Pacific Hwy, Tigard, OR 97223-8845 | 2015-08-26 |
1821438557 | Wendy Koga | Pharmacist | 11565 Sw Pacific Hwy, Tigard, OR 97223-8845 | 2013-06-26 |
1881030922 | Stewart James Monsey Jr. | Pharmacist | 11565 Sw Pacific Hwy, Tigard, OR 97223-8845 | 2013-05-16 |
1457691727 | Christian Yee | Pharmacist | 11565 Sw Pacific Hwy, Tigard, OR 97223-8845 | 2013-02-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
Find all providers in zip 97223 |
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 |
---|---|---|---|---|
1124577135 | Jayme Ryan Johnston | Pharmacist | 12442 Sw Scholls Ferry Rd Ste 205, Tigard, OR 97223 | 2016-10-03 |
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 |
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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.