Justin Tyler Miracle

Pharmacist · Corvallis, OR

Individual Active NPI

NPI number 1497354880

Practice location

777 NW Kings Blvd
Corvallis, OR 97330-5620
Phone
(541) 754-5583

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NPI record

NPI
1497354880
Entity type
Individual (Type 1)
Enumeration date
October 18, 2020
Last updated
November 15, 2023
Certified
November 15, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X RPH0018483 OR
Student in an Organized Health Care Education/Training Program 390200000X PI-0013024 OR

Other practice locations (1)

  • 3545 NE Canterbury Cir, Corvallis, OR 97330-4007 · (503) 877-4430

About Justin Miracle

Justin Tyler Miracle is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 777 NW Kings Blvd, Corvallis, OR 97330-5620. The NPI number 1497354880 was assigned on October 18, 2020 and the record was last updated on November 15, 2023.

Justin Miracle lists 2 licenses in the registry: #RPH0018483 (OR) for Pharmacist; #PI-0013024 (OR) for Student in an Organized Health Care Education/Training Program. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Justin Tyler Miracle?

The NPI number is 1497354880.

What is the phone number of Justin Miracle?

The phone number listed for the practice location is (541) 754-5583.

Where is Justin Miracle located?

777 NW Kings Blvd, Corvallis, OR 97330-5620.

What is the taxonomy code for Justin Miracle?

The primary taxonomy code is 183500000X – Pharmacist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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