Provider Demographics
NPI:1003351297
Name:SABADO-BABAL, PRUDENCIA FLORES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PRUDENCIA
Middle Name:FLORES
Last Name:SABADO-BABAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DESS
Other - Middle Name:FLORES
Other - Last Name:SABADO-BABAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2875 NW STUCKI AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5806
Mailing Address - Country:US
Mailing Address - Phone:971-310-2149
Mailing Address - Fax:971-310-3351
Practice Address - Street 1:2875 NW STUCKI AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5806
Practice Address - Country:US
Practice Address - Phone:971-310-2149
Practice Address - Fax:971-310-3351
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR78661835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1063969160OtherKAISER PERMANENTE