FRED MEYER
NPI 1063897239
Pharmacy - Community/Retail Pharmacy in Portland, OR

Q: What is Fred Meyer's NPI number?

The NPI number for Fred Meyer is 1063897239. It was assigned to this organization in the NPPES registry on July 29, 2015.

Q: What is Fred Meyer's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for Fred Meyer was last updated on July 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 29, 2015CLIA Certified · 3 labs

7404 N INTERSTATE AVE, PORTLAND, OR 97217(503) 286-6784(503) 286-6792 Get Directions Write a Review

NPPES record last updated: July 29, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fred Meyer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRED MEYER (NPI 1063897239) is a healthcare organization registered as a community/retail pharmacy in Portland, Oregon and active in the NPI registry since July 2015. The organization holds 3 active CLIA laboratory certificates and lists Le Kay Trang, Pharmacist Graduate Intern, as its authorized official.

NPPES Registry Identity

NPI1063897239

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameFRED MEYER

Location Address7404 N INTERSTATE AVEPortland, OR 97217-5528

Mailing Address7404 N Interstate AvePortland, OR 97217-5528 · (503) 286-6784 · Fax (503) 286-6792

Phone(503) 286-6784

Fax(503) 286-6792

Organization SubpartNo

Authorized OfficialLe Kay TrangPharmacist Graduate Intern · (503) 286-6784

Enumeration DateJuly 29, 2015

✔ NPI 1063897239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

7404 N INTERSTATE AVE, Portland, OR 97217

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CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D1001341

Fred Meyer Pharmacy #150 · Portland, OR

Active · expires Jul 8, 2028

CLIA Number38D1001341

Laboratory TypePharmacy

Certificate Effective DateJuly 9, 2026

Certificate Expiration DateJuly 8, 2028

Laboratory DirectorBrandon Thoreson

Laboratory Phone(503) 286-6784

Laboratory LocationFred Meyer Pharmacy #1507404 N Interstate Ave, Portland, OR 97217

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D0996100

Fred Meyer Pharmacy #360 · Portland, OR

Active · expires Feb 7, 2028

CLIA Number38D0996100

Laboratory TypeHealth Fair

Certificate Effective DateFebruary 8, 2026

Certificate Expiration DateFebruary 7, 2028

Laboratory DirectorMs. Stephanie Gaston

Laboratory Phone(503) 226-7179

Laboratory LocationFred Meyer Pharmacy #360100 NW 20th Place, Portland, OR 97209

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D0991460

Fred Meyer Pharmacy #075 · Portland, OR

Active · expires Sep 19, 2027

CLIA Number38D0991460

Laboratory TypePharmacy

Certificate Effective DateSeptember 20, 2025

Certificate Expiration DateSeptember 19, 2027

Laboratory DirectorWassim Ayoub

Laboratory Phone(503) 762-4436

Laboratory LocationFred Meyer Pharmacy #07514700 SE Division, Portland, OR 97236

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHAU MINH VO

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)