Provider Demographics
NPI:1962210997
Name:AL BALDAWI, REINA SAADOON MOHAMMED
Entity type:Individual
Prefix:DR
First Name:REINA
Middle Name:SAADOON MOHAMMED
Last Name:AL BALDAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13505 SW JENKINS RD APT 22
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1178
Mailing Address - Country:US
Mailing Address - Phone:971-330-5594
Mailing Address - Fax:
Practice Address - Street 1:7700 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2101
Practice Address - Country:US
Practice Address - Phone:503-203-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0020371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist