Healthcare Provider Details

I. General information

NPI: 1871824193
Provider Name (Legal Business Name): SUSANNE A VAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZSUZSANNA VAMOS

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 NE NELLY ST
HILLSBORO OR
97124-9404
US

IV. Provider business mailing address

7280 NE NELLY ST
HILLSBORO OR
97124-9404
US

V. Phone/Fax

Practice location:
  • Phone: 503-530-9080
  • Fax:
Mailing address:
  • Phone: 503-530-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0011840
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: