Provider Demographics
NPI:1649648486
Name:IWAKI, SHERYLLE LYNNE CADIENTE (PHARMD)
Entity type:Individual
Prefix:
First Name:SHERYLLE LYNNE
Middle Name:CADIENTE
Last Name:IWAKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SHERYLLE LYNNE
Other - Middle Name:MACADANGDANG
Other - Last Name:CADIENTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9155 SW BARNES RD STE 401
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6631
Mailing Address - Country:US
Mailing Address - Phone:503-216-8450
Mailing Address - Fax:971-712-2170
Practice Address - Street 1:9155 SW BARNES RD STE 401
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-216-6043
Practice Address - Fax:971-712-2170
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0014338183500000X, 1835P0018X
HIPH 3783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist