NPI 1275129793 · live from the CMS NPI Registry
Bill-Bern Balthazard
Pharmacy Technician in Portland, OR. National Provider Identifier 1275129793, active.
NPI record
| NPI | 1275129793 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy Technician 183700000X |
| Practice location | 1555 N Tomahawk Island Dr, Portland, OR 97217 |
| Practice phone | 503-205-9110 |
| Mailing address | 3250 Ne Broadway St Apt 240, Portland, OR 97232 |
| Enumerated | December 18, 2020 |
| Last updated | December 18, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy Technician | 183700000X | VA61112817 (WA) |
| Pharmacy Technician primary | 183700000X | CPT-0012541 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.