Provider Demographics
NPI:1386078541
Name:RASCHKOW, MARK DANIEL RATH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:DANIEL RATH
Last Name:RASCHKOW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13895 SW MERIDIAN ST UNIT 212
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2477
Mailing Address - Country:US
Mailing Address - Phone:406-855-2426
Mailing Address - Fax:
Practice Address - Street 1:58646 MCNULTY WAY STE 116
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-6210
Practice Address - Country:US
Practice Address - Phone:503-438-4543
Practice Address - Fax:503-438-4543
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist