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General NPI Number Information
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NPI Number | 1376031146
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Entity Type | Individual
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Provider Name | MATTHEW RALPH HOCTOR PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 1020 WASCO ST STE C
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City | HOOD RIVER
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State | OR
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Zip | 97031-1159
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Country | US
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Telephone | 518-708-9638
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Fax |
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Provider Business Mailing Address
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Address Line | 6821 SE MALL ST
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City | PORTLAND
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State | OR
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Zip | 97206-3573
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Country | US
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Telephone | 518-708-9638
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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-0016287
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 063843
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0016287
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License Number State | OR
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