# WILLAMETTE PHARMACY

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

## Provider details

- **NPI number:** 1528545969
- **Authorized official:** JOAN MORISKY (OWNER)
- **Authorized official phone:** (503) 542-1170

## Contact information

- **Practice address:** 10209 SE DIVISION BUILD B STE 100, PORTLAND, OR 97266
- **Practice address phone:** (503) 705-4105
- **Mailing address:** 10209 SE DIVISION BUILD B STE 100, PORTLAND, OR 97266
- **Mailing address phone:** (503) 705-4105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/27/2018
- **Last updated:** 07/27/2018