Healthcare Provider Details

I. General information

NPI: 1942141742
Provider Name (Legal Business Name): CYARRA MICHEAL SAUNDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SCYARRA MICHEAL SMITH

II. Dates (important events)

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

III. Provider practice location address

622 ROSE PARK LN NE
KEIZER OR
97303-4452
US

IV. Provider business mailing address

622 ROSE PARK LN NE
KEIZER OR
97303-4452
US

V. Phone/Fax

Practice location:
  • Phone: 425-616-6096
  • Fax:
Mailing address:
  • Phone: 425-616-6096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT-0030903
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: