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NPI Code Detail

MEDICARE: AMY JORGENSEN PHARMD

MEDICARE: AMY JORGENSEN PHARMD
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
1183500000XPharmacistPHRM.PH.60572119WA
2183500000XPharmacistRPH-0014890OR
31835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPHRM.PH.60572119WA
41835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH-0014890OR

General Provider Information

NPI Number : 1053783423
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY JORGENSEN PHARMD
Provider Business Mailing Address
First Line : 3800 SE 22ND AVE
Second Line : MAIL STOP 04002/34K
City : PORTLAND
State : OR
Zip : 97202-2918
Country : US
Telephone Number : 503-329-1855
Fax Number :
Provider Business Practice Location Address
First Line : 7411 NE 117TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-4706
Country : US
Telephone Number : 360-896-3533
Fax Number : 360-896-3527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2015
Last Update Date : 06/10/2026

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