Provider Demographics
NPI:1447801691
Name:FARIA, CHRISTIAN K (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:K
Last Name:FARIA
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 1:124 SE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-2304
Mailing Address - Country:US
Mailing Address - Phone:808-366-5224
Mailing Address - Fax:
Practice Address - Street 1:1120 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-2220
Practice Address - Country:US
Practice Address - Phone:541-523-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0017876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist