IndividualActive
Justin Miracle
NPI 1497354880 · Pharmacist · Corvallis, OR
Provider details
- NPI number
- 1497354880
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- PI-0013024 (OR)
Specialties & taxonomies
Pharmacy Service Providers
Student, Health Care
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
777 Nw Kings Blvd
Corvallis, OR 97330-5620
Phone: (541) 754-5583
Street-level locationGet directions
Mailing address
777 Nw Kings Blvd
Corvallis, OR 97330-5620
Additional practice locations (1)
- 3545 Ne Canterbury CirCorvallis, OR 97330-4007Phone: (503) 877-4430
Registry dates
- Enumerated
- 2020-10-18
- Last updated
- 2023-11-15
- Certified
- 2023-11-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.