Healthcare Provider Details

I. General information

NPI: 1770493058
Provider Name (Legal Business Name): COBY CATES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N 10TH AVE
STAYTON OR
97383-1311
US

IV. Provider business mailing address

1401 N 10TH AVE
STAYTON OR
97383-1311
US

V. Phone/Fax

Practice location:
  • Phone: 503-769-2175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH-0020448-P
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberRPH-0020448-P
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: