FRED MEYER PHARMACY #694
NPI 1629528344
Pharmacy - Community/Retail Pharmacy in Happy Valley, OR

Q: What is Fred Meyer Stores Inc's NPI number?

The NPI number for Fred Meyer Stores Inc is 1629528344. It was assigned to this organization in the NPPES registry on October 5, 2016. The provider is doing business as Fred Meyer Pharmacy #694.

Q: What is Fred Meyer Stores Inc's specialty?

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

Active since October 05, 2016CLIA 38D2120593 · Waiver

17005 SE SUNNYSIDE RD, HAPPY VALLEY, OR 97015(971) 999-6284(971) 999-6283 Get Directions Write a Review

NPPES record last updated: January 17, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 17, 2017, Nov 4, 2016, Oct 19, 2016 (3 updates tracked since 2016).

On this page

About Fred Meyer Pharmacy #694 NPPES

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

FRED MEYER PHARMACY #694 (NPI 1629528344) is a healthcare organization registered as a community/retail pharmacy in Happy Valley, Oregon and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through October 18, 2026 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1629528344

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameFRED MEYER STORES INC

Location Address17005 SE SUNNYSIDE RDHappy Valley, OR 97015-8724

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019

Phone(971) 999-6284

Fax(971) 999-6283

Organization SubpartNo

Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1263

Enumeration DateOctober 5, 2016

Last NPPES UpdateJanuary 17, 20173 updates tracked since enumeration

✔ NPI 1629528344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in OR · RP-0003223

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

17005 SE SUNNYSIDE RD, Happy Valley, OR 97015

Open in Google Maps ↗

Other Names 1

Doing Business AsFred Meyer Pharmacy #694

Other Identifiers 4

Medicaid1629528344OR

Medicare PINR119747

Medicare NSC0509530198

Other2164634Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.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 38D2120593

Fred Meyer Pharmacy #694 · Happy Valley, OR

Active · expires Oct 18, 2026

CLIA Number38D2120593

Laboratory TypePharmacy

Certificate Effective DateOctober 19, 2024

Certificate Expiration DateOctober 18, 2026

Laboratory DirectorKristi Denning

Laboratory Phone(971) 999-6284

Laboratory LocationFred Meyer Pharmacy #69417005 SE Sunnyside Rd, Happy Valley, OR 97086

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

210 services209 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

203 services202 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Fred Meyer Pharmacy #694 carries, from the Medicare DMEPOS supplier directory.

Fred Meyer Pharmacy #694

DMEPOS supplier · Happy Valley, OROperated by Fred Meyer Stores Inc

✔

Accepts Medicare assignment

Fred Meyer Pharmacy #694 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20681717

Medicare Participant SinceJuly 1, 1966

Supplier Location17005 SE Sunnyside RdHappy Valley, OR 97015

Phone(971) 999-6284

Supplier Specialties

Pharmacy

Medicare Product Categories

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Leave this field empty

Other Providers at the Same Location NPPES

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

MACKENZI BADGER

Student in an Organized Health Care Education/Training Program

17005 SE SUNNYSIDE RD
HAPPY VALLEY, OR 97015

Clackamas County (971) 999-6284

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 Fred Meyer Stores Inc's NPI number?

The NPI number for Fred Meyer Stores Inc is 1629528344. It was assigned to this organization in the NPPES registry on October 5, 2016. The provider is doing business as Fred Meyer Pharmacy #694.

Where is Fred Meyer Stores Inc located?

Fred Meyer Stores Inc is located at 17005 SE Sunnyside Rd, Happy Valley, OR 97015. The listed phone number is (971) 999-6284.

What is Fred Meyer Stores Inc's specialty?

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

Does Fred Meyer Stores Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Fred Meyer Pharmacy #694 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Fred Meyer Stores Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2120593) is associated with this NPI, valid through October 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fred Meyer Stores Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 44 other insurers list Fred Meyer Stores 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 Fred Meyer Stores Inc was last updated on January 17, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.