Provider Demographics
NPI:1306136734
Name:IRWIN, ADRIANE N (PHARMD, BCACP)
Entity type:Individual
Prefix:
First Name:ADRIANE
Middle Name:N
Last Name:IRWIN
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 NW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1267
Mailing Address - Country:US
Mailing Address - Phone:505-450-5241
Mailing Address - Fax:
Practice Address - Street 1:1190 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1267
Practice Address - Country:US
Practice Address - Phone:505-450-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007603183500000X
ORRPH-0013544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist