Healthcare Provider Details

I. General information

NPI: 1598237943
Provider Name (Legal Business Name): MATTHEW MCGREGOR PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2497 SE BURNSIDE RD
GRESHAM OR
97080-1246
US

IV. Provider business mailing address

2497 SE BURNSIDE RD
GRESHAM OR
97080-1299
US

V. Phone/Fax

Practice location:
  • Phone: 503-669-4233
  • Fax:
Mailing address:
  • Phone: 503-669-4233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPI-0013022
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0018796
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: