Individual
THERESA TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(503) 813-2000
Mailing address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(503) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
8158
OR
1835P2201X
Ambulatory Care Pharmacist
8158
OR
Other
Enumeration date
09/19/2016
Last updated
10/20/2016
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