MEDICARE: THERESA DIANE GATTI PHARMD, RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	0014947	OR
2	183500000X	Pharmacist	RPH-0014947	OR

General Provider Information

NPI Number	:	1376911511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA DIANE GATTI PHARMD, RPH

Provider Business Mailing Address
First Line	:	3450 COMMERCIAL ST SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-4682
Country	:	US
Telephone Number	:	503-585-3533
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 COMMERCIAL ST SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-4682
Country	:	US
Telephone Number	:	503-585-3533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2015
Last Update Date	:	06/03/2026

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