Wassim Ayoub, RPH
Individual provider Active NPI Pharmacist · Tualatin, OR
NPI 1649544883 · NPPES record last updated Mar 6, 2012
Key facts
- NPI
- 1649544883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10022 (OR)
- Practice address
- 19200 SW Martinazzi Ave
Tualatin, OR 97062-6357 - Phone
- (503) 691-4223
- Fax
- (503) 691-4220
- NPI assigned
- Mar 6, 2012
- 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 |
|---|---|---|---|
| 10022 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10022 | OR | Yes |
Addresses
Primary practice location
19200 SW Martinazzi Ave
Tualatin, OR 97062-6357
Mailing address
19200 SW Martinazzi Ave
Tualatin, OR 97062
Phone (503) 750-7787
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 Mar 6, 2012. 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.