{
"Npi": {
"NPI": "1649648486",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "IWAKI",
"FirstName": "SHERYLLE LYNNE",
"MiddleName": "CADIENTE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHARM.D",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CADIENTE",
"OtherFirstName": "SHERYLLE LYNNE",
"OtherMiddleName": "MACADANGDANG",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "9155 SW BARNES RD STE 401",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTLAND",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97225-6631",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-216-8450",
"MailingAddressFaxNumber": "971-712-2170",
"FirstLinePracticeLocationAddress": "9155 SW BARNES RD STE 401",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORTLAND",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97225",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-216-6043",
"PracticeLocationAddressFaxNumber": "971-712-2170",
"EnumerationDate": "09/10/2015",
"LastUpdateDate": "01/08/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "RPH-0014338",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "PH 3783",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1835P0018X",
"TaxonomyName": "Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"LicenseNumber": "RPH-0014338",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}