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NPI Code Detail

MEDICARE: BRANDI STONE PHARMACY TECHNICIAN

MEDICARE: BRANDI STONE PHARMACY TECHNICIAN
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
1183700000XPharmacy TechnicianCPT-0001450OR

General Provider Information

NPI Number : 1912594102
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI STONE PHARMACY TECHNICIAN
Provider Business Mailing Address
First Line : 6616 SE STEELE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97206-5324
Country : US
Telephone Number : 503-830-3910
Fax Number :
Provider Business Practice Location Address
First Line : 3527 SE 122ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97236-3401
Country : US
Telephone Number : 503-760-6688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2020
Last Update Date : 12/22/2020

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Directions to “ BRANDI STONE PHARMACY TECHNICIAN” Practice Location

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