# ASSURED PHARMACY NORTHWEST INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Assured Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245393016
- **Authorized official:** MR. FRANK TYLER ROBLES (CONTRACTING ADMINISTRATOR)
- **Authorized official phone:** (949) 222-9971

## Contact information

- **Practice address:** 3822 SE POWELL BLVD, PORTLAND, OR 97202-1720
- **Practice address phone:** (503) 238-4540
- **Practice address fax:** (503) 238-0323
- **Mailing address:** 17935 SKY PARK CIR STE F, IRVINE, CA 92614-4336
- **Mailing address phone:** (949) 222-9971
- **Mailing address fax:** (949) 271-5580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP-0002791 CS | OR | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3815365 | NCPDP | OR |