Cory Paul Arsenault
Individual provider Active NPI Pharmacist · Clackamas, OR
NPI 1073765871 · NPPES record last updated Jan 28, 2024
Key facts
- NPI
- 1073765871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10318 (OR)
- Practice address
- 10180 SE Sunnyside Rd
Inpatient Pharmacy
Clackamas, OR 97015-8970 - Phone
- (503) 571-4690
- NPI assigned
- Oct 13, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10318 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10318 | OR | Yes |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Inpatient Pharmacy
Clackamas, OR 97015-8970
Mailing address
10180 SE Sunnyside Rd
Inpatient Pharmacy
Clackamas, OR 97015-8970
Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.