MR. GARY EDWIN NELSON R.PH NPI 1396290201

NPI Information

  • NPI: 1396290201
  • Provider Name: MR. GARY EDWIN NELSON, R.PH
  • Classification: Pharmacist - 1835P0018X
  • Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Entity Type: Individual
  • Address: 1700 NE 102ND AVE
    PORTLAND, OR
    ZIP 97220
  • Phone: (866) 279-4581

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NPI Details

MR. Gary Edwin Nelson, R.PH is a pharmacist clinician (phc)/ clinical pharmacy specialist pharmacist in Portland, OR. The provider is pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. MR. Gary Edwin Nelson, R.PH NPI is 1396290201. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1700 NE 102ND AVE
PORTLAND, OR
ZIP 97220-804
Phone: (866) 279-4581

The enumeration date for this NPI number is 8/20/2016 and was last updated on 4/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11835P0018XPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist7022OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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