Provider Demographics
NPI:1225323926
Name:KITAMURA, MATTHEW (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:KITAMURA
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S GARDEN WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8173
Mailing Address - Country:US
Mailing Address - Phone:888-973-0498
Mailing Address - Fax:
Practice Address - Street 1:360 S GARDEN WAY STE 120
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8173
Practice Address - Country:US
Practice Address - Phone:888-973-0498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-11918183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist