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General NPI Number Information
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NPI Number | 1164931416
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Entity Type | Individual
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Provider Name | JORDAN L ZANGLA RPH, PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 08/11/2018
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Provider Practice Location Address
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Address Line | 18110 SE 34TH ST STE 270
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 800-330-3665
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Fax |
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Provider Business Mailing Address
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Address Line | 4717 SE HAWTHORNE BLVD APT 205
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City | PORTLAND
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State | OR
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Zip | 97215-3300
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Country | US
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Telephone | 443-617-5272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-0016149
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25179
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60823134
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License Number State | WA
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