Healthcare Provider Details

I. General information

NPI: 1649794751
Provider Name (Legal Business Name): CASSANDRA MARRUJO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSANDRA ABEYTA

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 SW US VETERANS HOSPITAL RD
PORTLAND OR
97239-2964
US

IV. Provider business mailing address

3710 SW US VETERANS HOSPITAL RD # P2PHAR
PORTLAND OR
97239-2964
US

V. Phone/Fax

Practice location:
  • Phone: 503-220-8262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberRPH-0014803-P
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number80212
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: