BEAVERTON PHARMACY
NPI 1548217136
Pharmacy - Community/Retail Pharmacy in Beaverton, OR

Active since May 28, 2006CLIA 38D2231327 · Waiver
12250 SW CANYON RD, BEAVERTON, OR 97005(503) 644-2101(503) 626-8698 Get Directions Write a Review

NPPES record last updated: December 12, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 12, 2019, Jan 17, 2017, Mar 31, 2016 (3 updates tracked since 2016).

About Beaverton Pharmacy NPPES

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

BEAVERTON PHARMACY (NPI 1548217136) is a healthcare organization registered as a community/retail pharmacy in Beaverton, Oregon and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through August 1, 2027 and lists Thomas Irby, President, as its authorized official.

NPPES Registry Identity

NPI1548217136
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBEAVERTON PHARMACY INC
Location Address12250 SW CANYON RDBeaverton, OR 97005-2116
Mailing Address12250 Sw Canyon RdBeaverton, OR 97005-2116 · (503) 644-2101 · Fax (503) 626-8698
Fax(503) 626-8698
Organization SubpartNo
Authorized OfficialThomas IrbyPresident · (503) 644-2101
Enumeration DateMay 28, 2006
Last NPPES UpdateDecember 12, 20193 updates tracked since enumeration
NPI 1548217136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in OR · RP-0000129-CS
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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
12250 SW CANYON RD, Beaverton, OR 97005

Other Names 1

Doing Business AsBeaverton Pharmacy

Other Identifiers 2

Medicaid007807OR
Other2148247Pk

Accepted 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 38D2231327

Beaverton Pharmacy · Beaverton, OR
Active · expires Aug 1, 2027
CLIA Number38D2231327
Laboratory TypePharmacy
Certificate Effective DateAugust 2, 2025
Certificate Expiration DateAugust 1, 2027
Laboratory DirectorThomas Wade Irby
Laboratory Phone(503) 644-2101
Laboratory LocationBeaverton Pharmacy12250 SW Canyon Rd, Beaverton, OR 97005
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 NPPES 5

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

Pharmacy (Community/Retail Pharmacy)
12250 SW CANYON RD, SUITE 200
BEAVERTON, OR 97005
Pharmacist
12250 SW CANYON RD
BEAVERTON, OR 97005
Pharmacist
12250 SW CANYON RD
BEAVERTON, OR 97005
Pharmacist
12250 SW CANYON RD
BEAVERTON, OR 97005
Pharmacy (Long Term Care Pharmacy)
12250 SW CANYON RD
BEAVERTON, OR 97005

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 Beaverton Pharmacy Inc's NPI number?

The NPI number for Beaverton Pharmacy Inc is 1548217136. It was assigned to this organization in the NPPES registry on May 28, 2006. The provider is doing business as Beaverton Pharmacy.

Where is Beaverton Pharmacy Inc located?

Beaverton Pharmacy Inc is located at 12250 SW Canyon Rd, Beaverton, OR 97005. The listed phone number is (503) 644-2101.

What is Beaverton Pharmacy Inc's specialty?

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

Does Beaverton Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2231327) is associated with this NPI, valid through August 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beaverton Pharmacy Inc 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 37 other insurers list Beaverton Pharmacy Inc 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 Beaverton Pharmacy Inc was last updated on December 12, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.