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General NPI Number Information
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NPI Number | 1508386319
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Entity Type | Individual
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Provider Name | CARLY MARIE HOLBERT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2017
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 3710 SW US VETERANS HOSPITAL RD
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City | PORTLAND
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State | OR
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Zip | 97239-2964
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Country | US
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Telephone | 503-220-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 STEINER ST APT E
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-4622
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Country | US
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Telephone | 813-215-1430
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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 | PS56286
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License Number State | FL
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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 | RPH91724
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License Number State | CA
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