Healthcare Provider Details

I. General information

NPI: 1144485491
Provider Name (Legal Business Name): JANE CHRISTINE OLYAEI BSPHARM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30299 SW BOONES FERRY RD
WILSONVILLE OR
97070-7844
US

IV. Provider business mailing address

30299 SW BOONES FERRY RD
WILSONVILLE OR
97070-7844
US

V. Phone/Fax

Practice location:
  • Phone: 503-682-4435
  • Fax: 503-570-2799
Mailing address:
  • Phone: 503-682-4435
  • Fax: 503-570-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0008691
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: