Healthcare Provider Details

I. General information

NPI: 1740198977
Provider Name (Legal Business Name): ALYANNA NICOLE PEKSON GARING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15995 SW WALKER RD
BEAVERTON OR
97006-4944
US

IV. Provider business mailing address

15995 SW WALKER RD
BEAVERTON OR
97006-4944
US

V. Phone/Fax

Practice location:
  • Phone: 503-690-5833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0021168
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: