Provider Demographics
NPI:1740612415
Name:HOWARD, ANDREW DAVID
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DAVID
Last Name:HOWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 CENTER ST NE
Mailing Address - Street 2:T-0608
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2905
Mailing Address - Country:US
Mailing Address - Phone:503-588-4433
Mailing Address - Fax:
Practice Address - Street 1:3790 CENTER ST NE
Practice Address - Street 2:T-0608
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2905
Practice Address - Country:US
Practice Address - Phone:503-588-4433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0013646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist