Provider Demographics
NPI:1396046827
Name:JUSON, DANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:JUSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16625 362ND AVE
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-9247
Mailing Address - Country:US
Mailing Address - Phone:503-668-2363
Mailing Address - Fax:503-668-2327
Practice Address - Street 1:9401 NE CASCADES PKWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-6824
Practice Address - Country:US
Practice Address - Phone:971-230-1931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR00119781835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist