IndividualActive
Jackson Leong, R.PH.
NPI 1679984850 · Geriatric Pharmacist · Portland, OR
Provider details
- NPI number
- 1679984850
- Entity type
- Individual
- Primary specialty
- Geriatric PharmacistPharmacy Service Providers
- Credential
- R.PH.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 7715 (OR)
Specialties & taxonomies
Pharmacy Service Providers
Pharmacy Service Providers
Practice location
16100 Sw 72nd Ave
Portland, OR 97224-7745
Phone: (503) 626-9436
Fax: (503) 372-1792
Approximate (ZIP-level) locationGet directions
Mailing address
16100 Sw 72nd Ave
Portland, OR 97224-7745
Registry dates
- Enumerated
- 2014-05-09
- Last updated
- 2014-05-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.