Provider Demographics
NPI:1447040720
Name:MIHYAWI, GHAITH
Entity type:Individual
Prefix:
First Name:GHAITH
Middle Name:
Last Name:MIHYAWI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9666 NE DORCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9096
Mailing Address - Country:US
Mailing Address - Phone:503-888-2374
Mailing Address - Fax:
Practice Address - Street 1:7010 NE CORNELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5422
Practice Address - Country:US
Practice Address - Phone:503-693-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0020517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist