Organization
NEW SEASONS MARKET PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA BUTLER (PHARMACY MANAGER)
(503) 467-4848
Entity
Organization
Contact information
Practice address
6400 N INTERSTATE AVE, PORTLAND, OR 97217-4834
(503) 467-4848
(503) 808-9911
Mailing address
6400 N INTERSTATE AVE, PORTLAND, OR 97217-4834
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002265CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278090
—
OR
01
—
3842110
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/22/2006
Last updated
08/22/2020
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