ANDREW VANDERWALL (NPI# 1912375825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912375825 |
| Entity Type | Individual |
| Full Name | ANDREW VANDERWALL |
| Practice Address |
1357 Monmouth St Independence OR 97351-1126 |
| Mailing Address |
916 W Evergreen Blvd Vancouver WA 98660-3035 |
| Practice Telephone | 5038382195 |
| Practice Fax Number | 5038383129 |
| Mailing Telephone | 3602132236 |
| Mailing Fax Number | 3602132238 |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2016-01-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH-0014885 | OR | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH-0014885 | OR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON RPH LICENSE | RPH-0014885 | 01 |
| Street Address |
1357 MONMOUTH ST |
| City | INDEPENDENCE |
| State | OR |
| Zip Code | 97351-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336108711 | Independence Pharmacy, Inc | Pharmacy | 1357 Monmouth St, Independence, OR 97351-1126 | 2006-03-22 |
| 1457959959 | Terry J Crowder | Pharmacist | 1357 Monmouth St, Independence, OR 97351-1126 | 2020-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598868515 | Independence-monmouth Family Medicine PC | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| 1821070111 | Kenneth R Winokur | Dentist | 329 South Main St, Independence, OR 97351 | 2005-11-14 |
| 1710044144 | Kenneth R Winokur Dmd PC | Dentist | 329 S Main St, Independence, OR 97351 | 2007-01-03 |
| 1407959422 | Keith Allen White | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| 1609901024 | Evan L Evans | Audiologist | 1343 A Monmouth St, Independence, OR 97351-0248 | 2007-02-23 |
| 1497703201 | Evergreen Oregon Healthcare Independence, L.L.C. | Skilled Nursing Facility | 1525 Monmouth St, Independence, OR 97351-1007 | 2006-05-04 |
| 1518127844 | David Patrick Mcdarby | Physical Therapist | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1881854115 | Bobbi Jo Shrum | Physical Therapy Assistant | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1639426208 | Central School District 13j | Local Education Agency (LEA) | 1610 Monmouth St, Independence, OR 97351-1008 | 2012-08-13 |
| 1851645931 | Holli Watkin | Nurse Practitioner | 1601 Monmouth St Ste 100, Independence, OR 97351-1019 | 2012-10-29 |
| Find all providers in zip 97351 | ||||
| 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 |
|---|---|---|---|---|
| 1841786183 | Ladonna Kaye Stephens | Pharmacist | 4100 Bolger Dr, Independence, MO 64055 | 2018-07-10 |
| 1386134880 | Sarah Denise-bradburn Nordt | Pharmacist | 205 N Pennsylvania Ave, Independence, KS 67301-3323 | 2018-05-10 |
| 1821400847 | Peter J Armato Jr. | Pharmacist | 52527 Piazza Rd, Independence, LA 70443-2464 | 2014-05-25 |
| 1336423623 | Susann Nance | Pharmacist | 17811 E 24 Hwy, Independence, MO 64056 | 2011-10-05 |
| 1053693754 | Michelle Hart | Pharmacist | 4120 S Jackson Dr Apt 305, Independence, MO 64057-1978 | 2011-09-19 |
| 1972825149 | Gary William Burgess | Pharmacist | 16200 E Us Highway 24, Independence, MO 64056-1521 | 2010-02-15 |
| 1497902548 | Tanya E Minkevich De Visser | Pharmacist | 4023 S Noland Rd, Independence, MO 64055-6507 | 2008-08-20 |
| 1275708331 | Jill Caracci | Pharmacist | 4545 South Noland Road, Independence, MO 64055 | 2008-04-29 |
| 1487740213 | Peter J Armato | Pharmacist | 539 West Railroad Ave, Independence, LA 70443 | 2006-10-05 |
| 1790779460 | Defever Osborn Drug | Pharmacist | 205 N Penn Ave, Independence, KS 67301-3323 | 2005-09-08 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 97351 |
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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.