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NPI Code Detail

MEDICARE: DAVE QUOC TAI LINDQVIST PHARMD

MEDICARE: DAVE QUOC TAI LINDQVIST 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
1183500000XPharmacistRPH-0018063OR

General Provider Information

NPI Number : 1588252191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVE QUOC TAI LINDQVIST PHARMD
Provider Business Mailing Address
First Line : 11190 SW BARNES RD
Second Line :
City : PORTLAND
State : OR
Zip : 97225-5372
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1555 N TOMAHAWK ISLAND DR
Second Line :
City : PORTLAND
State : OR
Zip : 97217-7912
Country : US
Telephone Number : 503-205-9110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2021
Last Update Date : 10/22/2021

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Directions to “ DAVE QUOC TAI LINDQVIST PHARMD” Practice Location

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