Provider Demographics
NPI:1487971891
Name:BUI, ANNIE S (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:S
Last Name:BUI
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 1:11727 SE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-3957
Mailing Address - Country:US
Mailing Address - Phone:503-901-4980
Mailing Address - Fax:
Practice Address - Street 1:11727 SE MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-3957
Practice Address - Country:US
Practice Address - Phone:503-901-4980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00127731835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist