Provider Demographics
NPI:1164822433
Name:VO, TOMMY (PHARMD)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:VO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2918
Mailing Address - Country:US
Mailing Address - Phone:503-797-5082
Mailing Address - Fax:503-797-5074
Practice Address - Street 1:3800 SE 22ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-2918
Practice Address - Country:US
Practice Address - Phone:503-797-5082
Practice Address - Fax:503-797-5074
Is Sole Proprietor?:No
Enumeration Date:2014-08-24
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0014237183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist