Provider Demographics
NPI:1457108847
Name:BRAIN-HERNANDEZ, CHRISTOPHER ELEAZAR (PHARMD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ELEAZAR
Last Name:BRAIN-HERNANDEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:ELEAZAR
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2324 20TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-5433
Mailing Address - Country:US
Mailing Address - Phone:805-758-7543
Mailing Address - Fax:
Practice Address - Street 1:3521 NW SAMARITAN DR LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4744
Practice Address - Country:US
Practice Address - Phone:541-768-5286
Practice Address - Fax:541-768-6662
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist