Individual
DR. JOVIN V PANTHAPATTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D. BCACP
Contact information
Practice address
178 SW 2ND AVE, CANBY, OR 97013-4152
(503) 416-4547
(503) 416-4553
Mailing address
7320 SW HUNZIKER RD STE 300, PORTLAND, OR 97223-2302
(035) 941-3033
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0016544-P
OR
1835P2201X
Ambulatory Care Pharmacist
Primary
RPH-0016544
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500758246
—
OR
Enumeration date
02/04/2015
Last updated
04/16/2020
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