Brandy Glynn Davis, PHARMD
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Sweet Home, OR
NPI 1730419441 · NPPES record last updated Jan 17, 2019
Key facts
- NPI
- 1730419441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- RPH-0016501 (OR)
- Practice address
- 1540 Main St
Sweet Home, OR 97386 - Phone
- (541) 367-0675
- Fax
- (541) 367-0678
- NPI assigned
- Dec 30, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00070315 | WA | MD | Pharmacist |
| RPH-0016501 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00070315 | WA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH-0016501 | OR | Yes |
Addresses
Primary practice location
1540 Main St
Sweet Home, OR 97386
Mailing address
1540 Main St
Sweet Home, OR 97386-1614
Phone (541) 367-0675
Other practice location 1
1540 Main St
Sweet Home, OR 97386
Phone (541) 367-0675
Other practice location 2
1350 Garrett St
Enumclaw, WA 98022-3468
Phone (360) 825-5739
Other providers in Sweet Home, OR
- Julia Cowan
- Sarah Crowe May
- Michael D. Crowe
- Danca Lenna Inc
- Keoni Danielson Kuwaye
- Kyle W Dimond
- Dennis Wayne Edgerly
- Nikki Claire Faulconer
- Karen Fox
- Elizabeth Gienger
All providers in Sweet Home, OR · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2019. 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.