Healthcare Provider Details

I. General information

NPI: 1194631903
Provider Name (Legal Business Name): VY LE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

IV. Provider business mailing address

1615 SW 197TH AVE
BEAVERTON OR
97003-2549
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0020171
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: