DR. JASON PENNELL (NPI# 1669922837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669922837 |
| Entity Type | Individual |
| Full Name | DR. JASON PENNELL |
| Credential | PHARMD |
| Practice Address |
19500 Se Stark St Portland OR 97233-5757 |
| Mailing Address |
17216 Ne 224th Ave Brush Prairie WA 98606-8104 |
| Practice Telephone | 8662802123 |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2020-02-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH-0015645 | OR | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0015645 | OR | Pharmacy Service Providers |
| Street Address |
19500 SE STARK ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-5757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427041961 | Patrick Kwong | Optometrist | 19500 Se Stark St, Portland, OR 97233-5757 | 2005-08-30 |
| 1487206108 | Yue Song | Student in an Organized Health Care Education/Training Program | 19500 Se Stark St, Portland, OR 97233-5757 | 2019-07-12 |
| 1942867965 | Joyce Trandem | Student in an Organized Health Care Education/Training Program | 19500 Se Stark St, Portland, OR 97233-5757 | 2019-05-24 |
| 1902462914 | Jessica Pham | Student in an Organized Health Care Education/Training Program | 19500 Se Stark St, Portland, OR 97233-5757 | 2019-05-15 |
| 1366909988 | Stephanie Radu | Student in an Organized Health Care Education/Training Program | 19500 Se Stark St, Portland, OR 97233-5757 | 2019-03-01 |
| 1336643105 | Tara Martin | Social Worker | 19500 Se Stark St, Portland, OR 97233-5757 | 2018-03-19 |
| 1760998066 | Lisa Ann M Wilson | Pharmacist | 19500 Se Stark St, Portland, OR 97233-5757 | 2017-12-21 |
| 1518471481 | Dustin Trung Khuu | Pharmacist | 19500 Se Stark St, Portland, OR 97233 | 2017-11-29 |
| 1437672193 | Gregory C Dalton | Counselor | 19500 Se Stark St, Portland, OR 97233-5757 | 2017-07-24 |
| 1891246989 | Kaiser Foundation Health Plan of The Northwest | General Practice | 19500 Se Stark St, Portland, OR 97233-5757 | 2016-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| 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 |
|---|---|---|---|---|
| 1407460371 | Samantha Nozomi Murata | Pharmacist | 5415 Sw Beaverton Ct Hwy, Portland, OR 97221 | 2020-09-08 |
| 1053923920 | Hoang Lan Ngoc Doan | Pharmacist | 4201 Ne 129th Pl, Portland, OR 97230-1405 | 2020-08-20 |
| 1528677531 | Mi Pham | Pharmacist | 5824 Se 134th Pl, Portland, OR 97236-2987 | 2020-07-26 |
| 1700407350 | Emad Banoub | Pharmacist | 1105 Hyw 181, Portland, TX 78374 | 2020-05-05 |
| 1255951471 | Nam Lai | Pharmacist | 2655 Se 50th Ave Apt 415, Portland, OR 97206-1577 | 2020-04-17 |
| 1275167439 | Mayasah Anas Sedeeq Al Bazzaz | Pharmacist | 15122 Nw Fig Ln, Portland, OR 97229-6986 | 2020-02-26 |
| 1427696632 | Thai Tran | Pharmacist | 7901 Se Powell Blvd, Portland, OR 97206-2314 | 2019-12-18 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1952966970 | Linda P. Pham | Pharmacist | 7901 Se Powell Blvd Ste K, Portland, OR 97206-2314 | 2019-05-06 |
| 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.