Provider Demographics
NPI:1386914174
Name:KHUT, RITHYA
Entity type:Individual
Prefix:
First Name:RITHYA
Middle Name:
Last Name:KHUT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30300 SW BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6889
Mailing Address - Country:US
Mailing Address - Phone:503-570-3533
Mailing Address - Fax:
Practice Address - Street 1:30300 SW BOONES FERRY RD
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-6889
Practice Address - Country:US
Practice Address - Phone:503-570-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPI-0010578183500000X
ORRPH-00132231835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist