MEDICARE: JENNIFER LIANG

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	RPH-0018719	OR
2	183500000X	Pharmacist	RPH-0018719	OR

General Provider Information

NPI Number	:	1831856889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LIANG

Provider Business Mailing Address
First Line	:	5850 NE PRESCOTT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97218-2232
Country	:	US
Telephone Number	:	503-284-7268
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 NE PRESCOTT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97218-2232
Country	:	US
Telephone Number	:	503-284-7268
Fax Number	:

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

Provider Enumeration Date	:	11/24/2021
Last Update Date	:	08/02/2023

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Directions to “ JENNIFER LIANG ” Practice Location

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