Provider Demographics
NPI:1740410620
Name:BZOWYCKYJ, ANDREW S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:BZOWYCKYJ
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:PO BOX 3808
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3808
Mailing Address - Country:US
Mailing Address - Phone:503-413-3900
Mailing Address - Fax:503-413-3710
Practice Address - Street 1:1960 NW 167TH PL STE 100
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4805
Practice Address - Country:US
Practice Address - Phone:503-672-6000
Practice Address - Fax:503-672-6001
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-25
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1197351835P1200X
MO20110244901835P1200X
CT113711835P1200X
ORRPH-0017037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy