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Organization
ISSE PHARMACY SERVICES
Active
Organization
ISSE PHARMACY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED ISSE PHARMD (OWNER/PHARMACIST)
(503) 908-0630
Entity
Organization
Contact information
Practice address
15635 SE 114TH AVE STE 101, CLACKAMAS, OR 97015-9028
(503) 908-0630
(503) 908-0865
Mailing address
15635 SE 114TH AVE STE 101, CLACKAMAS, OR 97015-9028
(503) 908-0630
(503) 908-0865
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
RP-0002831
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142223
PK
—
05
—
500667941
—
OR
Enumeration date
09/24/2013
Last updated
03/13/2020
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