Provider Demographics
NPI:1548578164
Name:HUNT, CHARMAINE L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHARMAINE
Middle Name:L
Last Name:HUNT
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 1:15748 BOONES WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3512
Mailing Address - Country:US
Mailing Address - Phone:503-939-2947
Mailing Address - Fax:503-893-6913
Practice Address - Street 1:4400 NE HALSEY ST
Practice Address - Street 2:BUILDING 2, FOURTH FLOOR
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213
Practice Address - Country:US
Practice Address - Phone:503-893-6908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00097761835P0018X
ORRPH00097761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy