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NPI Code Detail

MEDICARE: DR. SANDRA JOY RICKMAN PHARM.D., RPH

MEDICARE:  DR. SANDRA JOY RICKMAN  PHARM.D., RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH-0013286OR
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH0013286OR

General Provider Information

NPI Number : 1033477682
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANDRA JOY RICKMAN PHARM.D., RPH
Provider Business Mailing Address
First Line : 3930 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-1722
Country : US
Telephone Number : 503-772-4445
Fax Number :
Provider Business Practice Location Address
First Line : 3930 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-1722
Country : US
Telephone Number : 503-772-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2012
Last Update Date : 12/18/2015

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Directions to “ DR. SANDRA JOY RICKMAN PHARM.D., RPH” Practice Location

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