Provider Demographics
NPI:1134538580
Name:AHMADI, PARINAZ ANSARI (PHARMD)
Entity type:Individual
Prefix:
First Name:PARINAZ
Middle Name:ANSARI
Last Name:AHMADI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 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:503-391-2714
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
Practice Address - Country:US
Practice Address - Phone:503-378-1822
Practice Address - Fax:503-391-2714
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No183500000XPharmacy Service ProvidersPharmacist