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General NPI Number Information
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NPI Number | 1689331829
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Entity Type | Individual
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Provider Name | MATTHEW DENEFF PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-418-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 650 S GAINES ST APT 1117
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City | PORTLAND
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State | OR
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Zip | 97239-4768
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Country | US
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Telephone | 401-742-9628
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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-0018236
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 3165645
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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 | RPH-0018236
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License Number State | OR
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