Individual
DR. DANIELLE M CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-1758
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-1758
Taxonomy
Speciality
Code
Description
License number
State
1835P0200X
Pediatric Pharmacist
Primary
0012554
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0012554
LICENSE
OR
Enumeration date
10/17/2019
Last updated
10/17/2019
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