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NPI Code Detail

MEDICARE: PEACE TENIOLA OYEBODE PHARMD, BS, RPH

MEDICARE: PEACE TENIOLA OYEBODE PHARMD, BS, 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
1183500000XPharmacist70049701WA
2183500000XPharmacistRPH-0020686OR

General Provider Information

NPI Number : 1841161247
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEACE TENIOLA OYEBODE PHARMD, BS, RPH
Provider Business Mailing Address
First Line : 11835 NE GLENN WIDING DR
Second Line :
City : PORTLAND
State : OR
Zip : 97220-9057
Country : US
Telephone Number : 503-444-6523
Fax Number :
Provider Business Practice Location Address
First Line : 1718 E KESSLER BLVD
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-1842
Country : US
Telephone Number : 360-747-5800
Fax Number : 360-575-3846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2025
Last Update Date : 06/03/2026

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