Organization
MULTNOMAH COUNTY
Active
Other names
Fernhill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK MOTEN (DEPUTY DIRECTOR)
(503) 988-2966
Entity
Organization
Contact information
Practice address
5530 NE 42ND AVE, PORTLAND, OR 97218-1408
(503) 988-6625
Mailing address
619 NW 6TH AVE FL 5, PORTLAND, OR 97209-3991
(503) 988-7468
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022959
—
OR
Enumeration date
03/03/2025
Last updated
03/03/2025
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