IndividualActive
Jeffrey Dversdal
NPI 1104618362 · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Fairview, OR
Provider details
- NPI number
- 1104618362
- Entity type
- Individual
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- RPH-0010048 (OR)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
3768 Ne Fairview Lake Way
Fairview, OR 97024-7758
Phone: (503) 459-2474
Approximate (ZIP-level) locationGet directions
Mailing address
3768 Ne Fairview Lake Way
Fairview, OR 97024-7758
Registry dates
- Enumerated
- 2025-05-21
- Last updated
- 2025-05-21
- Certified
- 2025-05-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.