Provider Demographics
NPI:1649038316
Name:SHARAKY, ALSHAIMAA ADEL
Entity type:Individual
Prefix:
First Name:ALSHAIMAA
Middle Name:ADEL
Last Name:SHARAKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5758 NW CRADY LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-2342
Mailing Address - Country:US
Mailing Address - Phone:503-888-0650
Mailing Address - Fax:
Practice Address - Street 1:13470 NW CORNELL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5820
Practice Address - Country:US
Practice Address - Phone:503-646-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist