Provider Demographics
NPI:1659016426
Name:VOSIKA, SAMANTHA E (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:E
Last Name:VOSIKA
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 1:20121 SE STARK ST APT 245
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-6065
Mailing Address - Country:US
Mailing Address - Phone:503-740-6684
Mailing Address - Fax:
Practice Address - Street 1:25699 SE STARK ST
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-3305
Practice Address - Country:US
Practice Address - Phone:503-665-9766
Practice Address - Fax:503-665-9337
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist