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NPI Code Detail

MEDICARE: MS. WINNIE PEDRO RPH

MEDICARE: MS. WINNIE PEDRO 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
1183500000XPharmacist0008722OR
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist0008722OR

General Provider Information

NPI Number : 1770849135
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. WINNIE PEDRO RPH
Provider Business Mailing Address
First Line : 6850 N LOMBARD ST
Second Line :
City : PORTLAND
State : OR
Zip : 97203-6247
Country : US
Telephone Number : 503-240-2733
Fax Number : 503-240-2724
Provider Business Practice Location Address
First Line : 6850 N LOMBARD ST
Second Line :
City : PORTLAND
State : OR
Zip : 97203-6247
Country : US
Telephone Number : 503-240-2733
Fax Number : 503-240-2724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2012
Last Update Date : 04/20/2017

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