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NPI Code Detail

MEDICARE: DR. JOSEPH EDWARD KING IV PHARM-D

MEDICARE: DR. JOSEPH EDWARD KING IV PHARM-D
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-0013214OR
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH-0013214OR

General Provider Information

NPI Number : 1831562065
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH EDWARD KING IV PHARM-D
Provider Business Mailing Address
First Line : 625 SE MILLER AVE
Second Line :
City : DALLAS
State : OR
Zip : 97338-2634
Country : US
Telephone Number : 503-623-2400
Fax Number : 503-623-5799
Provider Business Practice Location Address
First Line : 625 SE MILLER AVE
Second Line :
City : DALLAS
State : OR
Zip : 97338-2634
Country : US
Telephone Number : 503-623-2400
Fax Number : 503-623-5799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2015
Last Update Date : 02/02/2021

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