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Organization
MULTNOMAH COUNTY OREGON
Active
Organization
MULTNOMAH COUNTY OREGON
Active
Other names
WESTSIDE HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE KODER PHARMD (PHARMACY DIRECTOR)
(503) 988-7278
Entity
Organization
Contact information
Practice address
619 NW 6TH AVE FL 1, PORTLAND, OR 97209-3964
(503) 988-5267
(503) 988-5781
Mailing address
619 NW 6TH AVE FL 7, PORTLAND, OR 97209-3964
(503) 988-5267
(503) 988-4345
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RP-0000960-CS
OR
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123653
—
OR
01
—
2078375
PK
—
Enumeration date
07/30/2006
Last updated
11/08/2019
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