Provider Demographics
NPI:1124329297
Name:BURNS, JENNY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 SE HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2945
Mailing Address - Country:US
Mailing Address - Phone:503-232-3930
Mailing Address - Fax:503-232-3715
Practice Address - Street 1:2800 SE HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2945
Practice Address - Country:US
Practice Address - Phone:503-232-3930
Practice Address - Fax:503-232-3715
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10993183500000X, 1835P0018X
CA52159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist