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CREDENA HEALTH PHARMACY ST VINCENT
NPI 1225190408
Pharmacy - Community/Retail Pharmacy in Portland, OR

Active since December 14, 2006CLIA 38D2216207 · Waiver
9155 SW BARNES RD STE 102, PORTLAND, OR 97225(503) 216-2630(503) 216-2637 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 7, 2023, Apr 5, 2023, Jan 21, 2022 and 3 more (6 updates tracked since 2019).

About Credena Health Pharmacy St Vincent NPPES

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

CREDENA HEALTH PHARMACY ST VINCENT (NPI 1225190408) is a healthcare organization registered as a community/retail pharmacy in Portland, Oregon and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through March 9, 2027 and lists Mike Skafi, Avp/secretary, as its authorized official.

NPPES Registry Identity

NPI1225190408
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameCREDENA HEALTH LLC
Location Address9155 SW BARNES RD STE 102Portland, OR 97225-6625
Mailing AddressPo Box 2704Portland, OR 97208-2704
Phone(503) 216-2630
Fax(503) 216-2637
Organization SubpartNo
Authorized OfficialMike SkafiAvp/secretary · (575) 650-3396
Enumeration DateDecember 14, 2006
Last NPPES UpdateDecember 7, 20236 updates tracked since enumeration
NPPES CertifiedDecember 4, 2023
✔ NPI 1225190408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
9155 SW BARNES RD STE 102, Portland, OR 97225
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Other Names 1

Other NameCredena Health Pharmacy St Vincent

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 38D2216207

Credena Health Pharmacy St Vincent · Portland, OR
Active · expires Mar 9, 2027
CLIA Number38D2216207
Laboratory TypePharmacy
Certificate Effective DateMarch 10, 2025
Certificate Expiration DateMarch 9, 2027
Laboratory DirectorDanika Kusuma
Laboratory Phone(503) 216-2630
Laboratory LocationCredena Health Pharmacy St Vincent9155 SW Barnes Mob 2, Floor 1, Suite 102, Portland, OR 97225
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
69 services69 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
55 services55 patients

Medical Equipment Supplier Medicare DMEPOS 4

Medicare supplier enrollment and the product categories Credena Health Pharmacy St Vincent carries, from the Medicare DMEPOS supplier directory.

Credena Health Pharmacy St Vincent

DMEPOS supplier · Portland, OROperated by Credena Health LLC
✔

Accepts Medicare assignment

Credena Health Pharmacy St Vincent agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20481815
Medicare Participant SinceOctober 22, 2015
Supplier Location9155 SW Barnes Rd Ste 102Portland, OR 97225
Phone(503) 216-2630
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES

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

JOVANA KALEM PHARMD
Pharmacist
9155 SW BARNES RD STE 102
PORTLAND, OR 97225
Washington County (503) 216-2630

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Credena Health LLC's NPI number?

The NPI number for Credena Health LLC is 1225190408. It was assigned to this organization in the NPPES registry on December 14, 2006. The provider is also known as Credena Health Pharmacy St Vincent.

Where is Credena Health LLC located?

Credena Health LLC is located at 9155 SW Barnes Rd Ste 102, Portland, OR 97225. The listed phone number is (503) 216-2630.

What is Credena Health LLC's specialty?

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

Does Credena Health LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Credena Health Pharmacy St Vincent accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Credena Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2216207) is associated with this NPI, valid through March 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Credena Health LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 49 other insurers list Credena Health LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Credena Health LLC was last updated on December 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.