TIMOTHY TERRENCE PETERSON (NPI# 1730518044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730518044 |
| Entity Type | Individual |
| Full Name | TIMOTHY TERRENCE PETERSON |
| Credential | PHARMD |
| Practice Address |
4500 Commercial St Se Salem OR 97302-3918 |
| Practice Telephone | 5035882352 |
| Mailing Telephone | 5035882352 |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH-0013816 | OR | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023178738 | Timothy Lee Peterson | Pharmacist | 1010 Enterprise Dr E, Belle Plaine, MN 56011-2340 | 2006-12-11 |
| 1992887376 | Timothy K. Peterson | Physician Assistant | 2891 E Grant St, Roma, TX 78584 | 2006-10-19 |
| 1609956481 | Timothy John Peterson | Chiropractor | 10135 Hwy Ss, Bloomer, WI 54724 | 2006-10-16 |
| 1528041886 | Timothy D Peterson | Emergency Medicine | 108 Sutton Place, Taos Ski Valley, NM 87525-0067 | 2005-11-21 |
| 1265049043 | Timothy Charles Peterson | Pharmacist | 1400 E 2nd St, Edmond, OK 73034-5321 | 2020-09-25 |
| 1740742725 | Timothy Scott Peterson | Student in an Organized Health Care Education/Training Program | 2301 Erwin Rd, Durham, NC 27705-4699 | 2019-04-01 |
| 1497259360 | Timothy James Peterson | Student in an Organized Health Care Education/Training Program | 1740 W Taylor St, Chicago, IL 60612-7232 | 2018-03-23 |
| 1992189328 | Timothy James Peterson | Counselor | 12025 115th Ave Ne, Bldg D Suite 200, Kirkland, WA 98034-6942 | 2015-07-15 |
| 1922362490 | Timothy Peterson | Family Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2012-06-29 |
| 1720388218 | Timothy Warren Peterson | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2010-10-30 |
| Street Address |
4500 COMMERCIAL ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588954184 | William R. Croco | Pharmacist | 4500 Commercial St Se, Salem, OR 97302-3918 | 2011-04-15 |
| 1073097408 | Svetlana Cooper | Pharmacist | 4500 Commercial St Se, Salem, OR 97302-3918 | 2018-09-21 |
| 1275038663 | Tara Jade Koretsky | Pharmacist | 4500 Commercial St Se, Salem, OR 97302-3918 | 2018-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| 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 |
|---|---|---|---|---|
| 1194356493 | Katherine Janssen | Pharmacist | 875 Oak St Se # 1090, Salem, OR 97301-3975 | 2020-01-27 |
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1982263141 | Darla York | Pharmacist | 502 Highway 62 W, Salem, AR 72576-8400 | 2019-06-11 |
| 1083182372 | Virgil A Guthrie | Pharmacist | 648 Thompson Ave Ne, Salem, OR 97301-2753 | 2018-11-05 |
| 1538645262 | Joo Hyeon Kim | Pharmacist | 3509 Commercial St Se Ste 3507, Salem, OR 97302-3829 | 2018-07-16 |
| 1578086021 | Courtney Parker | Pharmacist | 25 Pelham Rd Ste 104, Salem, NH 03079-4872 | 2017-07-17 |
| 1710359476 | Albert Folsom | Pharmacist | 2757 22nd St Se, Salem, OR 97302-1553 | 2015-10-21 |
| 1558799312 | Tamara Dean Mccollum | Pharmacist | 7 Harbour View Dr, Salem, SC 29676-4513 | 2013-10-14 |
| 1790027431 | Rebecca Cauble Marshall | Pharmacist | #3 Public Square, Salem, IN 47167-9430 | 2013-03-20 |
| 1346587300 | Caitlin Laucka Paarlberg | Pharmacist | 2360 Foxfield Ln, Salem, VA 24153-4740 | 2013-01-10 |
| Find all providers in SALEM | ||||
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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.