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General NPI Number Information
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NPI Number | 1477886117
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Entity Type | Individual
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Provider Name | SANDRA LEE ANDERSON RPH
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Gender | Female
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 9945 SW KENT CT
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City | TIGARD
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State | OR
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Zip | 97224-4553
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Country | US
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Telephone | 503-620-0337
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Fax |
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Provider Business Mailing Address
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Address Line | 9945 SW KENT CT
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City | TIGARD
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State | OR
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Zip | 97224-4553
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Country | US
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Telephone | 503-620-0337
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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 | 5863
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | 5863
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License Number State | OR
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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 | 5863
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License Number State | OR
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