Provider Demographics
NPI:1811649437
Name:POORMOHAMADIAN, REYHANEH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REYHANEH
Middle Name:
Last Name:POORMOHAMADIAN
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 1:2964 SHADOW VIEW DR APT 284
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7581
Mailing Address - Country:US
Mailing Address - Phone:209-829-8910
Mailing Address - Fax:
Practice Address - Street 1:145 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4107
Practice Address - Country:US
Practice Address - Phone:541-683-9684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy