1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Pharmacy
  6. NPI Profile

PROVIDENCE PORTLAND MEDICAL CENTER PHARMACY
NPI 1386034312
Pharmacy - Community/Retail Pharmacy in Portland, OR

Active since January 29, 2015
4805 NE GLISAN ST, PORTLAND, OR 97213(503) 215-6080 Get Directions Write a Review

NPPES record last updated: January 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Portland Medical Center Pharmacy NPPES

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

PROVIDENCE PORTLAND MEDICAL CENTER PHARMACY (NPI 1386034312) is a healthcare organization registered as a community/retail pharmacy in Portland, Oregon and active in the NPI registry since January 2015. The organization lists Tavis Smith, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1386034312
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePROVIDENCE HEALTH & SERVICE - OREGON
Location Address4805 NE GLISAN STPortland, OR 97213-2933
Mailing Address4805 Ne Glisan StPortland, OR 97213-2933 · (503) 215-6080
Phone(503) 215-6080
Organization SubpartNo
Authorized OfficialTavis SmithOperations Manager · (503) 215-6296
Enumeration DateJanuary 29, 2015
✔ NPI 1386034312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in OR · RP-0000780
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
4805 NE GLISAN ST, Portland, OR 97213
Open in Google Maps ↗

Other Names 1

Doing Business AsProvidence Portland Medical Center Pharmacy

Other Identifiers 1

Other2149074Pk

Other Providers at the Same Location NPPES 20

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

SALONA SHRESTHA MD
Internal Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-2392
PROVIDENCE HEALTH & SERVICES - OREGON
General Acute Care Hospital
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 451-3000
DR. ROBERT THOMAS MARTIN M.D.
Emergency Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 297-6334
CECILIA BRADFORD CRNA
Nurse Anesthetist, Certified Registered
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-1111
PROVIDENCE HEALTH & SERVICES - OREGON
Psychiatric Unit
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-4323
GITA D GELFER DO
Hospitalist
4805 NE GLISAN ST, STE BG05
PORTLAND, OR 97213
Multnomah County (503) 215-2392
MECCA CARTER
Doula
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-1111
JESUS ERNESTO CONRIQUE GARCIA
Nurse's Aide
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-1111

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 Providence Health & Service - Oregon's NPI number?

The NPI number for Providence Health & Service - Oregon is 1386034312. It was assigned to this organization in the NPPES registry on January 29, 2015. The provider is doing business as Providence Portland Medical Center Pharmacy.

Where is Providence Health & Service - Oregon located?

Providence Health & Service - Oregon is located at 4805 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 215-6080.

What is Providence Health & Service - Oregon's specialty?

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

When was this NPI record last updated?

The NPPES record for Providence Health & Service - Oregon was last updated on January 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.