Kent Blair, RPH
Individual provider Active NPI Pharmacist · Tualatin, OR
NPI 1265800486 · NPPES record last updated Sep 3, 2015
Key facts
- NPI
- 1265800486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 7146 (OR)
- Practice address
- 20800 SW 115TH Ave # 100
Tualatin, OR 97062-6863 - Phone
- (503) 906-6831
- NPI assigned
- Sep 3, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7146 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7146 | OR | Yes |
Addresses
Primary practice location
20800 SW 115TH Ave # 100
Tualatin, OR 97062-6863
Mailing address
20800 SW 115TH Ave # 100
Tualatin, OR 97062-6863
Phone (503) 906-6831
Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2015. 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.