IndividualActive
Justin Nicholls, PHARMD, BCOP, BCPS
NPI 1891790549 · Pharmacist · Portland, OR
Provider details
- NPI number
- 1891790549
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- PHARMD, BCOP, BCPS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 3984 (MT)
Specialties & taxonomies
Pharmacy Service Providers
Pharmacy Service Providers
Pharmacy Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
1201 Ne Lloyd Blvd
Ste 510
Portland, OR 97232-1202
Phone: (971) 678-9127
Street-level locationGet directions
Mailing address
1450 N Prescott St
Portland, OR 97217-3202
Registry dates
- Enumerated
- 2005-06-18
- Last updated
- 2014-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.