Healthcare Provider Details

I. General information

NPI: 1932026622
Provider Name (Legal Business Name): ANNEJELYN RANESES DELLINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12240 SW SCHOLLS FERRY RD
TIGARD OR
97223-3354
US

IV. Provider business mailing address

12240 SW SCHOLLS FERRY RD
TIGARD OR
97223-3354
US

V. Phone/Fax

Practice location:
  • Phone: 503-590-7346
  • Fax:
Mailing address:
  • Phone: 503-590-7346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0021085
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: