Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1861940769 Individual Practitioner Male Practitioner

Michael A Grossnickle , RPH

Pharmacist • Portland, OR

Professional Overview & Biography Verified Profile Summary

Michael Grossnickle, RPH is a registered healthcare professional specializing in Pharmacist in Portland, OR. Practice services are available at 5420 NE 33RD AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5420 Ne 33rd Ave

Portland, OR 972117404

Telephone 9712300153
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1114934098

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Portland, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.0 Yrs
Regional Practice Density
942 Specialists

Practicing in Portland, OR (3654 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-07-08
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License OR RPH-0015591

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
500750146 (OR)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Annie Chen

Pharmacist

NPI 1093422818
Wan-Wen Yeh

Pharmacist

NPI 1174838742
Jennifer Kim

Pharmacist

NPI 1215160536
Louis Nguyen

Pharmacist

NPI 1225634587
NPI 1346784766

Doctor of Pharmacy (Pharm.D.)

NPI 1750831491

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location May 20, 2021

Registered at 5420 NE 33RD AVE, PORTLAND, OR 972117404 (Tel: 9712300153)

📍
Updated Business Mailing Address May 20, 2021

Registered at 1776 SW MADISON ST, PORTLAND, OR 972051715 (Tel: 5032241044)

NPI Profile Active September 20, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 20, 2016

Registered at 6116 NE MARTIN LUTHER KING BLVD, PORTLAND, OR 972113159 (Tel: 5032820612)

📍
Updated Business Mailing Address September 20, 2016

Registered at 6116 NE MARTIN LUTHER KING BLVD, PORTLAND, OR 972113159 (Tel: 5032820612)

👤
Provider Name / Credentials Updated September 20, 2016

Recorded as MICHAEL GROSSNICKLE, RPH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2016

Pharmacist (License #RPH-0015591 in OR)

🟢
Initial NPI Registration & Enumeration September 20, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861940769
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2016
Last Update: July 08, 2022
Sole Proprietor: No

Mailing Address

1776 Sw Madison St

Portland, OR 972051715

Phone: 5032241044

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.