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General NPI Number Information
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NPI Number | 1396555207
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Entity Type | Individual
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Provider Name | GIBRAN BISWAS PHARMD
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Gender |
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 5452 RIVER RD N
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City | KEIZER
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State | OR
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Zip | 97303-4699
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Country | US
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Telephone | 503-393-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 60 SE 10TH AVE APT 203
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City | PORTLAND
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State | OR
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Zip | 97214-1366
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Country | US
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Telephone | 412-641-0484
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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 | RP458852
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License Number State | PA
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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 | RPH-0020291
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License Number State | OR
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