KRISTIN KRUSKAMP (NPI# 1679017081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679017081 |
| Entity Type | Individual |
| Full Name | KRISTIN KRUSKAMP |
| Credential | PHARMD |
| Practice Address |
9800 Se Sunnyside Rd Clackamas OR 97015-9750 |
| Mailing Address |
20152 Chanticleer Pl Oregon City OR 97045-7145 |
| Practice Telephone | 1866280080 |
| Mailing Telephone | 9714047799 |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2020-04-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH-0015691 | OR | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0015691 | OR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PHARMD | RPH-0015691 | 01 |
| Street Address |
9800 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-9750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144210949 | Stasha Anne Hornbeck | Dietitian, Registered | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2005-10-24 |
| 1386283620 | Aaron Joseph David | Student in an Organized Health Care Education/Training Program | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2020-01-03 |
| 1902469281 | Brooke N Garofalo | Student in an Organized Health Care Education/Training Program | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2019-04-22 |
| 1144789777 | Amber Sue Osborn | Registered Nurse | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2019-03-13 |
| 1841770013 | Ellen Anderson | Occupational Therapist | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2018-08-17 |
| 1447747266 | Keri Lynne Barnett | Registered Nurse | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2018-04-17 |
| 1437671617 | Amber Marie Morrison | Physician Assistant | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2017-07-10 |
| 1649715947 | Nora E Lee | Pharmacist | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-12-22 |
| 1902348857 | Michaela Zucker | Dietitian, Registered | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-11-09 |
| 1174075527 | Erin Skoff | Pharmacist | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| 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 |
|---|---|---|---|---|
| 1982989562 | Kate Stelly Jelline | Pharmacist | 16000 Se Evelyn St, Clackamas, OR 97015-9519 | 2011-10-14 |
| 1588965602 | Cameron J Mccarthy | Pharmacist | 16800 Se Evelyn St, Clackamas, OR 97015-9512 | 2010-11-04 |
| 1881225241 | Jocelyn Mason | Pharmacist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-03 |
| 1023535895 | Karyn Nafey | Pharmacist | 16300 Se Evelyn St, Clackamas, OR 97015-9515 | 2017-08-23 |
| 1386189595 | Darin Ferry | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-12-23 |
| 1649715947 | Nora E Lee | Pharmacist | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-12-22 |
| 1891247797 | Christopher Curtis Caswell | Pharmacist | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-10-26 |
| 1518419555 | Janene Tamborello | Pharmacist | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-10-25 |
| 1366993776 | Donna Jean Touchette | Pharmacist | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-10-20 |
| 1912458944 | Kimberly Brownell | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-10-14 |
| Find all providers in CLACKAMAS | ||||
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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.