Healthcare Provider Details

I. General information

NPI: 1568750990
Provider Name (Legal Business Name): PATRICIA POSTEUCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 ARBOR DR
WEST LINN OR
97068-1104
US

IV. Provider business mailing address

2602 ARBOR DR
WEST LINN OR
97068-1104
US

V. Phone/Fax

Practice location:
  • Phone: 503-756-4919
  • Fax: 503-699-7633
Mailing address:
  • Phone: 503-756-4919
  • Fax: 503-699-7633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number550107010172228
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: