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NPI Code Detail

MEDICARE: KIAN GHATAN

MEDICARE: KIAN GHATAN
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-0015782OR
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist0015782OR

General Provider Information

NPI Number : 1538603592
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIAN GHATAN
Provider Business Mailing Address
First Line : 16575 SW PENINSULA CT
Second Line :
City : BEAVERTON
State : OR
Zip : 97006-7968
Country : US
Telephone Number : 503-839-1077
Fax Number :
Provider Business Practice Location Address
First Line : 1839 MOLALLA AVE
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-4071
Country : US
Telephone Number : 503-657-1483
Fax Number : 503-657-1480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2016
Last Update Date : 04/25/2017

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Directions to “ KIAN GHATAN ” Practice Location

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