Healthcare Provider Details

I. General information

NPI: 1548414915
Provider Name (Legal Business Name): DANE URABE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 SW BEAVERTON HILLSDALE HWY
PORTLAND OR
97225-2008
US

IV. Provider business mailing address

7280 SW BEAVERTON HILLSDALE HWY
PORTLAND OR
97225-2008
US

V. Phone/Fax

Practice location:
  • Phone: 503-296-7454
  • Fax: 503-296-7258
Mailing address:
  • Phone: 503-296-7454
  • Fax: 503-296-7258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0009996
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: