Provider Demographics
NPI:1306129424
Name:ROMANAGGI, THOMAS VICTOR (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:VICTOR
Last Name:ROMANAGGI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10775 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3001
Mailing Address - Country:US
Mailing Address - Phone:503-207-0646
Mailing Address - Fax:
Practice Address - Street 1:10775 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3001
Practice Address - Country:US
Practice Address - Phone:503-207-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist