Provider Demographics
NPI:1467888909
Name:MALABANAN, KRISTEN LANGIT (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LANGIT
Last Name:MALABANAN
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 1:1180 NE 63RD WAY UNIT 1002
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6790
Mailing Address - Country:US
Mailing Address - Phone:310-480-0474
Mailing Address - Fax:
Practice Address - Street 1:14700 SE MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-1417
Practice Address - Country:US
Practice Address - Phone:503-652-4133
Practice Address - Fax:503-652-4120
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0013747183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist