Provider Demographics
NPI:1558621474
Name:ABBASPOUR, ABBAS (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:ABBAS
Middle Name:
Last Name:ABBASPOUR
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22075 NW IMBRIE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7578
Mailing Address - Country:US
Mailing Address - Phone:503-747-4113
Mailing Address - Fax:503-747-1127
Practice Address - Street 1:22075 NW IMBRIE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97209-1029
Practice Address - Country:US
Practice Address - Phone:503-747-1133
Practice Address - Fax:503-747-1127
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6512183500000X
ORRPH-00062511835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist