Provider Demographics
NPI:1033562392
Name:SZYMKOWIAK, REBECCA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:SZYMKOWIAK
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:COWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 NW 21ST AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1791
Mailing Address - Country:US
Mailing Address - Phone:630-639-9099
Mailing Address - Fax:
Practice Address - Street 1:416 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2907
Practice Address - Country:US
Practice Address - Phone:503-483-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0015405183500000X
OR0015405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist