Provider Demographics
NPI:1598135964
Name:SOWLES, ANDREW (PHARMD, BCACP, BCPS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:SOWLES
Suffix:
Gender:M
Credentials:PHARMD, BCACP, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 OAK ST SE
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:966 12TH ST SE
Practice Address - Street 2:STE 130
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2859
Practice Address - Country:US
Practice Address - Phone:503-814-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00141891835P0018X, 1835P2201X, 1835P1200X
OR0014189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy