Provider Demographics
NPI:1760081475
Name:FARRINGTON, FORREST ROGER (RPH)
Entity Type:Individual
Prefix:MR
First Name:FORREST
Middle Name:ROGER
Last Name:FARRINGTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16683 SE JESSICA ERIN LN
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-5283
Mailing Address - Country:US
Mailing Address - Phone:503-621-2134
Mailing Address - Fax:
Practice Address - Street 1:3500 SE 26TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-2901
Practice Address - Country:US
Practice Address - Phone:503-797-2100
Practice Address - Fax:503-797-2330
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORORRPH0007986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist