Healthcare Provider Details

I. General information

NPI: 1720907868
Provider Name (Legal Business Name): ALENA NAMTHIP AROUNPRADITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N 12TH ST STE 508
PHOENIX AZ
85006-2849
US

IV. Provider business mailing address

17205 SW WATERCREST CT
BEAVERTON OR
97006-4148
US

V. Phone/Fax

Practice location:
  • Phone: 602-839-3927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2025045952
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: