Individual
DR. ANDREW HIBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
315 SW 5TH AVE, PORTLAND, OR 97204-1703
(503) 416-3395
Mailing address
66612 ORIOLE RD, NORTH BEND, OR 97459-9490
(269) 599-0857
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0014909
OR
1835G0303X
Geriatric Pharmacist
RPH-0014909
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0014909
OR
1835P2201X
Ambulatory Care Pharmacist
RPH-0014909
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH0014909
PHARMACIST LICENSE NUMBER FOR THE STATE OF OREGON
OR
Enumeration date
08/26/2015
Last updated
05/16/2024
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