Provider Demographics
NPI:1841574019
Name:SAULSBURY, ERIC LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:LEE
Last Name:SAULSBURY
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 1:2103 W BURNSIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3519
Mailing Address - Country:US
Mailing Address - Phone:503-295-6480
Mailing Address - Fax:503-295-6543
Practice Address - Street 1:2103 W BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3519
Practice Address - Country:US
Practice Address - Phone:503-295-6480
Practice Address - Fax:503-295-6543
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65851183500000X
OR00141241835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist