Organization
OREGON HEALTH & SCIENCE UNIVERSITY
Active
Other names
OHSU GABRIEL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANNE SMITH (VICE PRESIDENT, ERC)
(503) 494-4817
Entity
Organization
Contact information
Practice address
4411 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 494-2098
(503) 494-2255
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE: CR9-4 PHARMACY COMPLIANCE, PORTLAND, OR 97239-3011
(503) 494-8007
(503) 494-5094
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336I0012X
Institutional Pharmacy
RP0002250CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046485
—
WA
05
—
1982797155
—
ID
05
—
242116
—
OR
01
—
3842083
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PH027OR
—
AK
Enumeration date
10/02/2006
Last updated
10/06/2025
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