Healthcare Provider Details

I. General information

NPI: 1083552525
Provider Name (Legal Business Name): LODESTAR COLLABORATIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19699 SUN CIR
WEST LINN OR
97068-1913
US

IV. Provider business mailing address

19699 SUN CIR
WEST LINN OR
97068-1913
US

V. Phone/Fax

Practice location:
  • Phone: 720-648-2949
  • Fax:
Mailing address:
  • Phone: 720-648-2949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VIII. Authorized Official

Name: HYOJIN SUNG
Title or Position: OWNER/ LEAD PHARMACIST
Credential: PHARMD
Phone: 720-648-2949