Provider Demographics
NPI:1003497090
Name:FERRI, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FERRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 E TYEE DR
Mailing Address - Street 2:
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759-9407
Mailing Address - Country:US
Mailing Address - Phone:408-309-5193
Mailing Address - Fax:
Practice Address - Street 1:596 E TYEE DR
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759-9407
Practice Address - Country:US
Practice Address - Phone:408-309-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH44259183500000X
ORRPH0010372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist