# NEW SEASONS MARKET PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063433035
- **Authorized official:** MELINDA BUTLER (PHARMACY MANAGER)
- **Authorized official phone:** (503) 467-4848

## Contact information

- **Practice address:** 6400 N INTERSTATE AVE, PORTLAND, OR 97217-4834
- **Practice address phone:** (503) 467-4848
- **Practice address fax:** (503) 808-9911
- **Mailing address:** 6400 N INTERSTATE AVE, PORTLAND, OR 97217-4834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP0002265CS | OR | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 278090 | — | OR |
| 01 | — | 3842110 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |