Provider Demographics
NPI:1649794751
Name:MARRUJO, CASSANDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MARRUJO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:ABEYTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3710 SW US VETERANS HOSPITAL RD # P2PHAR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0014803-P1835P1300X
CA802121835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric