Healthcare Provider Details

I. General information

NPI: 1841818549
Provider Name (Legal Business Name): ADAM JOSE ESCOTO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 NW HARRIMAN ST STE 161
BEND OR
97703-1947
US

IV. Provider business mailing address

1128 NW HARRIMAN ST STE 161
BEND OR
97703-1947
US

V. Phone/Fax

Practice location:
  • Phone: 541-633-7159
  • Fax:
Mailing address:
  • Phone: 541-633-7159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61072357
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0018268
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: