Provider Demographics
NPI:1346812443
Name:SUNDAY, DYLAN HUNTER (CPHT, CCMA)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:HUNTER
Last Name:SUNDAY
Suffix:
Gender:M
Credentials:CPHT, CCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 SW BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5932
Mailing Address - Country:US
Mailing Address - Phone:503-608-2706
Mailing Address - Fax:
Practice Address - Street 1:1555 N TOMAHAWK ISLAND DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-7912
Practice Address - Country:US
Practice Address - Phone:503-205-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT-0013212183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORCPT-0013212OtherOREGON BOARD OF PHARMACY