David Arthur Andersen, R.PH.
Individual provider Active NPI Pharmacist · Gresham, OR
NPI 1962719138 · NPPES record last updated Sep 8, 2010
Key facts
- NPI
- 1962719138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH-0004828 (OR)
- Practice address
- 4285 W Powell Blvd
Gresham, OR 97030-5050 - Phone
- (503) 492-2922
- Fax
- (503) 492-8060
- NPI assigned
- Sep 8, 2010
- 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 |
|---|---|---|---|
| RPH 26652 | CA | MD | Pharmacist |
| RPH-0004828 | OR | MD | Pharmacist |
| PH 00007363 | WA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 00007363 | WA | |
| Pharmacist | 183500000X | RPH-0004828 | OR | Yes |
| Pharmacist | 183500000X | RPH 26652 | CA |
Addresses
Primary practice location
4285 W Powell Blvd
Gresham, OR 97030-5050
Mailing address
4285 W Powell Blvd
Gresham, OR 97030-5050
Phone (503) 492-2922
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2010. 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.