MEDICARE: JOANNE C. TAYLOR 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	183500000X	Pharmacist	RPH-0007114	OR
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH-0007114	OR

General Provider Information

NPI Number	:	1720389661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE C. TAYLOR RPH

Provider Business Mailing Address
First Line	:	401 A AVE
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-3037
Country	:	US
Telephone Number	:	503-675-4486
Fax Number	:	503-675-4488

Provider Business Practice Location Address
First Line	:	401 A AVE
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-3037
Country	:	US
Telephone Number	:	503-675-4486
Fax Number	:	503-675-4488

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

Provider Enumeration Date	:	11/09/2010
Last Update Date	:	12/28/2015

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Directions to “ JOANNE C. TAYLOR RPH” Practice Location

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