MR. JUSTIN TYLER MIRACLE
NPI 1497354880
Pharmacist in Corvallis, OR

Active since October 18, 2020
777 NW KINGS BLVD, CORVALLIS, OR 97330(541) 754-5583 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 15, 2023, Oct 18, 2020 (2 updates tracked since 2020).

About Mr. Justin Tyler Miracle NPPES

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

MR. JUSTIN TYLER MIRACLE (NPI 1497354880) is an individual pharmacist in Corvallis, Oregon, licensed in Oregon (RPH0018483) and active in the NPI registry since October 2020. He maintains a secondary practice location in Corvallis.

NPPES Registry Identity

NPI1497354880
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameMR. JUSTIN TYLER MIRACLE
Location Address777 NW KINGS BLVDCorvallis, OR 97330-5620
Mailing Address777 Nw Kings BlvdCorvallis, OR 97330-5620 · (503) 877-4430
Sole ProprietorNo
Enumeration DateOctober 18, 2020
Last NPPES UpdateNovember 15, 20232 updates tracked since enumeration
NPPES CertifiedNovember 15, 2023
NPI 1497354880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in OR · RPH0018483
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License PI-0013024 (OR)
777 NW KINGS BLVD, Corvallis, OR 97330

Secondary Practice Location 1

Location 13545 NE Canterbury CirCorvallis, OR 97330-4007 · Phone (503) 877-4430

Other Providers at the Same Location NPPES 7

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

Pharmacist
777 NW KINGS BLVD
CORVALLIS, OR 97330
Pharmacist
777 NW KINGS BLVD
CORVALLIS, OR 97330
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
777 NW KINGS BLVD
CORVALLIS, OR 97330
Pharmacy (Community/Retail Pharmacy)
777 NW KINGS BLVD
CORVALLIS, OR 97330
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
777 NW KINGS BLVD
CORVALLIS, OR 97330
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
777 NW KINGS BLVD
CORVALLIS, OR 97330
Pharmacist
777 NW KINGS BLVD
CORVALLIS, OR 97330

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 Justin Miracle's NPI number?

The NPI number for Justin Miracle is 1497354880. It was assigned to this individual provider in the NPPES registry on October 18, 2020.

Where is Justin Miracle located?

Justin Miracle practices at 777 NW Kings Blvd, Corvallis, OR 97330. The listed phone number is (541) 754-5583.

What is Justin Miracle'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 Justin Miracle was last updated on November 15, 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.