LISA ANN M WILSON


Address: 19500 Se Stark St, Portland, OR 97233-5757
Phone: 5036744766

LISA ANN M WILSON (NPI# 1760998066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760998066
Entity Type Individual
Full Name LISA ANN M WILSON
Credential RPH
Practice Address 19500 Se Stark St
Portland
OR 97233-5757
Mailing Address 12447 Se William Otty Rd
Happy Valley
OR 97086-6278
Practice Telephone 5036744766
Enumeration Date 2017-12-21
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1835P0018X Pharmacist
Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0008146 OR Pharmacy Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
19500 Se Stark St, Portland, OR 972335757 5036744766

Other Providers LISA WILSON

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1184225062 Lisa Diane Wilson Pharmacist 5600 Landers Road, Sherwood, AR 72117 2020-11-05
1386282358 Lisa May Wilson Registered Nurse 563 Landings Blvd, Ann Arbor, MI 48103-2715 2019-12-20
1720507163 Lisa M Wilson Massage Therapist 19833 Road 124, Tulare, CA 93274-9597 2017-09-18
1639535545 Lisa Wilson Social Worker 12004 Lansdowne Rd, Austin, TX 78754-5873 2016-01-07
1073809018 Lisa Zobrist Wilson Nurse Practitioner 10844 Thistlewood Dr, Baton Rouge, LA 70810-2921 2011-06-28
1215178777 Lisa Wilson Counselor 4826 5th St Nw, Washington, DC 20011-6107 2009-03-13
1235386699 Lisa Elaine Wilson Counselor 1052 Gardner Rd Ste 700, Charleston, SC 29407-5702 2008-08-27
1083877559 Lisa Marie Wilson Emergency Medicine 925 Seneca St., Mailstop H6-ed, Virginia Mason Medical Center, Seattle, WA 98101 2008-07-05
1295918076 Lisa Ann Wilson Anesthesiology 304 S Jones Blvd, Las Vegas, NV 89107-2623 2007-12-14
1518175629 Lisa Dawn Wilson Occupational Therapist 550 Thornton Pkwy Unit 110, Thornton, CO 80229-2166 2007-05-21

Office Location

Street Address 19500 SE STARK ST
City PORTLAND
State OR
Zip Code 97233-5757

Providers in the same location

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
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
1669922837 Jason Pennell Pharmacist 19500 Se Stark St, Portland, OR 97233-5757 2016-10-11
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 1835P0018X
Grouping Pharmacy Service Providers
Classification Pharmacist
Specialization Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
1245695956 M. Katherine Welch Pharmacist 3228 Sw Water Ave, Portland, OR 97239-4632 2015-12-22
1790176006 Jacob Tang Pharmacist 1940 Se 12th Ave Apt 9, Portland, OR 97214-4779 2015-02-09
1902211196 Danit Chetron Pharmacist 2323 Sw Caldew St, Portland, OR 97219-2618 2014-06-25
1023350881 Joey Goren Degrood Pharmacist 9044 Sw Rystadt Ln, Portland, OR 97225-2851 2013-03-20
1831435213 James L Huang Pharmacist 300 N Graham St Ste 200, Portland, OR 97227 2012-12-12
1972853331 Sharon Leigh Pharmacist 4531 Se Belmont St. Suite 100, Portland, OR 97215-1675 2012-09-13
1649544107 Ryan Bradley Pharmacist 6348 Ne Halsey St Ste A, Portland, OR 97213-4720 2012-03-01
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Competitor

Search similar providers

City PORTLAND
Zip Code 97233

Improve Information

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Dataset Information

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.

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