Provider Demographics
NPI:1497076137
Name:RETA, ALISON MARIE (PHARMD, CDCES)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MARIE
Last Name:RETA
Suffix:
Gender:F
Credentials:PHARMD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6149
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-0149
Mailing Address - Country:US
Mailing Address - Phone:503-352-8150
Mailing Address - Fax:503-352-6087
Practice Address - Street 1:2725 SW CEDAR HILLS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1435
Practice Address - Country:US
Practice Address - Phone:503-352-8150
Practice Address - Fax:503-352-6087
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR611561835P2201X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care