Provider Demographics
NPI:1720370315
Name:SABA, DEKABO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEKABO
Middle Name:
Last Name:SABA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7440 N DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-5630
Mailing Address - Country:US
Mailing Address - Phone:503-286-5680
Mailing Address - Fax:503-286-5290
Practice Address - Street 1:7440 N DENVER AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-5630
Practice Address - Country:US
Practice Address - Phone:503-286-5680
Practice Address - Fax:503-286-5290
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-14
Last Update Date:2011-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0812741-2Medicaid
OR0812741-2Medicaid
OR0812741-2Medicare UPIN
OR0812741-2Medicare PIN