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CREDENA HEALTH CLINIC
NPI 1366101966
Pharmacy - Community/Retail Pharmacy in Portland, OR

Active since December 10, 2021CLIA 38D2216197 · Waiver
5050 NE HOYT ST STE 222, PORTLAND, OR 97213(503) 215-9968 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 7, 2023, Apr 12, 2022, Dec 10, 2021 (3 updates tracked since 2021).

About Credena Health Clinic NPPES

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

CREDENA HEALTH CLINIC (NPI 1366101966) is a healthcare organization registered as a community/retail pharmacy in Portland, Oregon and active in the NPI registry since December 2021. 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

NPI1366101966
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameCREDENA HEALTH LLC
Location Address5050 NE HOYT ST STE 222Portland, OR 97213-2980
Mailing AddressPo Box 2704Portland, OR 97208-2704
Phone(503) 215-9968
Organization SubpartNo
Authorized OfficialMike SkafiAvp/secretary · (575) 650-3396
Enumeration DateDecember 10, 2021
Last NPPES UpdateDecember 7, 20233 updates tracked since enumeration
NPPES CertifiedDecember 4, 2023
✔ NPI 1366101966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
5050 NE HOYT ST STE 222, Portland, OR 97213
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Other Names 1

Doing Business AsCredena Health Clinic

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 38D2216197

Credena Health Clinic · Portland, OR
Active · expires Mar 9, 2027
CLIA Number38D2216197
Laboratory TypePharmacy
Certificate Effective DateMarch 10, 2025
Certificate Expiration DateMarch 9, 2027
Laboratory DirectorDanika Kusuma
Laboratory Phone(503) 215-9968
Laboratory LocationCredena Health Clinic5050 NE Hoyt Street, Suite 222, Portland, OR 97213
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

MR. ERIC JON SCHETTINI PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
5050 NE HOYT ST STE 222
PORTLAND, OR 97213
Multnomah County (503) 215-9968
MARIA ANTONIA RIVERA PHARMD
Pharmacist
5050 NE HOYT ST STE 222
PORTLAND, OR 97213
Multnomah County (503) 215-9968

Frequently Asked Questions

What is CREDENA HEALTH LLC's NPI number?

The NPI number assigned to this healthcare provider is 1366101966, enumerated as an "organization" on December 10, 2021.

Where is the provider located?

The provider is located at 5050 NE HOYT ST STE 222 PORTLAND, OR 97213 and the phone number is (503) 215-9968.

What is the provider's specialty?

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.