Provider Demographics
NPI:1063812063
Name:STEWARD, ANDREEA DIANA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREEA
Middle Name:DIANA
Last Name:STEWARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10635 SE TURNBERRY LOOP
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-6994
Mailing Address - Country:US
Mailing Address - Phone:503-784-6252
Mailing Address - Fax:
Practice Address - Street 1:3300 SE DWYER DR STE 304
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6548
Practice Address - Country:US
Practice Address - Phone:503-513-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00142901835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist