Provider Demographics
NPI:1629404561
Name:HERRERA, JANETTE (RPH)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:
Last Name:HERRERA
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 1:33454 SW CHINOOK PLZ
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-3731
Mailing Address - Country:US
Mailing Address - Phone:503-543-6316
Mailing Address - Fax:503-543-3548
Practice Address - Street 1:33454 SW CHINOOK PLZ
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-3731
Practice Address - Country:US
Practice Address - Phone:503-543-6316
Practice Address - Fax:503-543-3548
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0007757183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist