Healthcare Provider Details

I. General information

NPI: 1225447816
Provider Name (Legal Business Name): OKSANA POLITO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38241 PROCTOR BLVD
SANDY OR
97055-8019
US

IV. Provider business mailing address

10860 SE OAK ST
MILWAUKIE OR
97222-6694
US

V. Phone/Fax

Practice location:
  • Phone: 503-668-1384
  • Fax:
Mailing address:
  • Phone: 503-652-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0014164
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: