Provider Demographics
NPI:1508332131
Name:JAYAWEERA, NIPUNEE
Entity Type:Individual
Prefix:DR
First Name:NIPUNEE
Middle Name:
Last Name:JAYAWEERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SE 7TH AVE STE 1500
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 SE 7TH AVE STE 1500
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4171
Practice Address - Country:US
Practice Address - Phone:503-516-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00106481835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care