Provider Demographics
NPI:1538313978
Name:YI, SOKHEMRY PENH (RPH)
Entity Type:Individual
Prefix:
First Name:SOKHEMRY
Middle Name:PENH
Last Name:YI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36288 SW BALD PEAK RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-9031
Mailing Address - Country:US
Mailing Address - Phone:503-628-4987
Mailing Address - Fax:
Practice Address - Street 1:14600 SW MURRAY SCHOLLS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-9712
Practice Address - Country:US
Practice Address - Phone:503-579-1878
Practice Address - Fax:503-579-0988
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist