Gerissa Abdon
Individual provider Active NPI Pharmacist · Beaverton, OR
NPI 1487364014 · NPPES record last updated Dec 5, 2022
Key facts
- NPI
- 1487364014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH0019272 (OR)
- Practice address
- 14625 SW Allen Blvd
Beaverton, OR 97007-3697 - Phone
- (503) 643-2724
- NPI assigned
- Dec 5, 2022
- Sex
- Female
- 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 |
|---|---|---|---|
| RPH0019272 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH0019272 | OR | Yes |
Addresses
Primary practice location
14625 SW Allen Blvd
Beaverton, OR 97007-3697
Mailing address
14625 SW Allen Blvd
Beaverton, OR 97007-3697
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2022. 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.