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NPI Code Detail

MEDICARE: MEGHAN PIETRACCINI

MEDICARE: MEGHAN PIETRACCINI
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
1183500000XPharmacist16812OR

General Provider Information

NPI Number : 1720479207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN PIETRACCINI
Provider Business Mailing 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 : 503-205-9120
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 : 503-205-9120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2015
Last Update Date : 10/03/2022

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Directions to “ MEGHAN PIETRACCINI ” Practice Location

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