Provider Demographics
NPI:1588965602
Name:MCCARTHY, CAMERON J (RPH)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:J
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22243 RIVERSIDE DR NE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:OR
Mailing Address - Zip Code:97137-9721
Mailing Address - Country:US
Mailing Address - Phone:503-476-4167
Mailing Address - Fax:
Practice Address - Street 1:16800 SE EVELYN ST
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9512
Practice Address - Country:US
Practice Address - Phone:503-338-8365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR65291835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist