THAYNE EDWARD VICKSTROM
NPI 1265705768
Pharmacist in Corvallis, OR

Active since February 14, 2012
1555 SW 53RD ST, CORVALLIS, OR 97333(541) 758-3392(541) 758-4159 Get Directions Write a Review

NPPES record last updated: February 14, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Thayne Edward Vickstrom NPPES

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

THAYNE EDWARD VICKSTROM (NPI 1265705768) is an individual pharmacist in Corvallis, Oregon, licensed in Oregon (9544) and active in the NPI registry since February 2012.

NPPES Registry Identity

NPI1265705768
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameTHAYNE EDWARD VICKSTROM
Location Address1555 SW 53RD STCorvallis, OR 97333-2630
Mailing Address1555 Sw 53rd StCorvallis, OR 97333-2630 · (541) 758-3392 · Fax (541) 758-4159
Fax(541) 758-4159
Sole ProprietorNo
Enumeration DateFebruary 14, 2012
NPI 1265705768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in OR · 9544
Definition
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.
1555 SW 53RD ST, Corvallis, OR 97333

Other Identifiers 1

Other9544OR · State Pharmacist License

Other Providers at the Same Location NPPES 4

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

Pharmacist
1555 SW 53RD ST
CORVALLIS, OR 97333
Pharmacy
1555 SW 53RD ST
CORVALLIS, OR 97333
Pharmacist
1555 SW 53RD ST
CORVALLIS, OR 97333
Pharmacist
1555 SW 53RD ST
CORVALLIS, OR 97333

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 Thayne Vickstrom's NPI number?

The NPI number for Thayne Vickstrom is 1265705768. It was assigned to this individual provider in the NPPES registry on February 14, 2012.

Where is Thayne Vickstrom located?

Thayne Vickstrom practices at 1555 SW 53rd St, Corvallis, OR 97333. The listed phone number is (541) 758-3392.

What is Thayne Vickstrom's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Thayne Vickstrom was last updated on February 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.