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Individual

NISSE PENG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH, PHARMD

Contact information

Practice address
1303 NW LOVEJOY ST, PORTLAND, OR 97209-2785
(503) 205-6751
(503) 205-6750
Mailing address
1303 NW LOVEJOY ST, PORTLAND, OR 97209-2785
(503) 205-6751
(503) 205-6750

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-11103
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-11103
OR

Other

Enumeration date
11/15/2006
Last updated
06/28/2016
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