Provider Demographics
NPI:1902211196
Name:CHETRON, DANIT (RPH)
Entity Type:Individual
Prefix:MS
First Name:DANIT
Middle Name:
Last Name:CHETRON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 SW CALDEW ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2618
Mailing Address - Country:US
Mailing Address - Phone:503-317-7519
Mailing Address - Fax:
Practice Address - Street 1:2323 SW CALDEW ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2618
Practice Address - Country:US
Practice Address - Phone:503-317-7519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR95001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist