Provider Demographics
NPI:1285285809
Name:JOO, DEANNA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:
Last Name:JOO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20740 SW HOUSTON DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8723
Mailing Address - Country:US
Mailing Address - Phone:907-727-8304
Mailing Address - Fax:
Practice Address - Street 1:21320 SW LANGER FARMS PKWY
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9105
Practice Address - Country:US
Practice Address - Phone:503-825-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0017370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist