Provider Demographics
NPI:1568046035
Name:ACOBA, WHITNEY YANOS (PHARMD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:YANOS
Last Name:ACOBA
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 1:20151 SE HIGHWAY 212
Mailing Address - Street 2:
Mailing Address - City:BORING
Mailing Address - State:OR
Mailing Address - Zip Code:97089-9220
Mailing Address - Country:US
Mailing Address - Phone:808-658-7000
Mailing Address - Fax:
Practice Address - Street 1:20151 SE HIGHWAY 212
Practice Address - Street 2:
Practice Address - City:BORING
Practice Address - State:OR
Practice Address - Zip Code:97089-9220
Practice Address - Country:US
Practice Address - Phone:503-689-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist