Provider Demographics
NPI:1396555207
Name:BISWAS, GIBRAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GIBRAN
Middle Name:
Last Name:BISWAS
Suffix:
Gender:U
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SE 10TH AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1366
Mailing Address - Country:US
Mailing Address - Phone:412-641-0484
Mailing Address - Fax:
Practice Address - Street 1:5452 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4699
Practice Address - Country:US
Practice Address - Phone:503-393-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458852183500000X
ORRPH-0020291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist