Basic Information
| Provider Information | |||||||||
| NPI: | 1285285809 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOO | ||||||||
| FirstName: | DEANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20740 SW HOUSTON DR | ||||||||
| Address2: | |||||||||
| City: | SHERWOOD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971408723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077278304 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21320 SW LANGER FARMS PKWY | ||||||||
| Address2: | |||||||||
| City: | SHERWOOD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971409105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038254053 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2019 | ||||||||
| LastUpdateDate: | 09/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | RPH-0017370 | OR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.