Provider Demographics
NPI:1992005490
Name:TOOMEY, PETER SHAWN
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:SHAWN
Last Name:TOOMEY
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 1:1140 N SPRINGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2007
Mailing Address - Country:US
Mailing Address - Phone:503-538-2430
Mailing Address - Fax:
Practice Address - Street 1:1140 N SPRINGBROOK RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2007
Practice Address - Country:US
Practice Address - Phone:503-538-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-30
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0010805183500000X
ORRPH-00108051835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist