Provider Demographics
NPI:1053698142
Name:MISTEREK, BELINDA (RPH)
Entity type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:
Last Name:MISTEREK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14840 SE WEBSTER RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-3249
Mailing Address - Country:US
Mailing Address - Phone:503-303-1090
Mailing Address - Fax:503-303-1075
Practice Address - Street 1:14840 SE WEBSTER RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-3249
Practice Address - Country:US
Practice Address - Phone:503-303-1090
Practice Address - Fax:503-303-1075
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0008530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist