Provider Demographics
NPI:1851761621
Name:DAM, TRINITY (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:
Last Name:DAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CAM VAN
Other - Middle Name:
Other - Last Name:DAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5250 COMMERCIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-1018
Mailing Address - Country:US
Mailing Address - Phone:503-378-1822
Mailing Address - Fax:
Practice Address - Street 1:5250 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-1018
Practice Address - Country:US
Practice Address - Phone:503-378-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00149841835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist