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NPI Code Detail

MEDICARE: DR. ALI OLYAEI

MEDICARE:  DR. ALI  OLYAEI
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
11835P1200XPharmacotherapy PharmacistRPH-0007764OR

General Provider Information

NPI Number : 1730795212
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALI OLYAEI
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3098
Country : US
Telephone Number : 503-494-8132
Fax Number :
Provider Business Practice Location Address
First Line : 13852 AMBERWOOD CIR
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-6716
Country : US
Telephone Number : 503-830-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2020
Last Update Date : 09/19/2020

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Directions to “ DR. ALI OLYAEI ” Practice Location

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