Provider Demographics
NPI:1437399714
Name:GRAALUM, DIANA CELESTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:CELESTE
Last Name:GRAALUM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SW MARKET ST FL 11
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5715
Mailing Address - Country:US
Mailing Address - Phone:503-276-1951
Mailing Address - Fax:
Practice Address - Street 1:1621 SW FIRST AVE.
Practice Address - Street 2:WOOLWORTH BLDG 2ND FLOOR
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201
Practice Address - Country:US
Practice Address - Phone:503-276-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0009727183500000X
CA49257183500000X
IDP4896183500000X
IDP7937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist