Provider Demographics
NPI:1982332094
Name:CARGILE, CAMERON SCOTT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:SCOTT
Last Name:CARGILE
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 1:14968 SE BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5446
Mailing Address - Country:US
Mailing Address - Phone:530-355-3837
Mailing Address - Fax:
Practice Address - Street 1:4320 SE KING RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-5281
Practice Address - Country:US
Practice Address - Phone:503-303-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0019032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist