Provider Demographics
NPI:1245552983
Name:NGUYEN, JASMINE (PHARMD)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:NGUYEN
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 1:10275 SE CRESCENT RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-3044
Mailing Address - Country:US
Mailing Address - Phone:360-450-9194
Mailing Address - Fax:
Practice Address - Street 1:7901 SE POWELL BLVD STE J
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-2314
Practice Address - Country:US
Practice Address - Phone:360-450-9194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0013430183500000X
WAPH00067943183500000X
ORRPH0013430P1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist