EBISA DERESSA
NPI 1003224064
Pharmacist in Portland, OR

Active since July 22, 2014
1123 N HAYDEN MEADOWS DR, PORTLAND, OR 97217(503) 205-6661(503) 205-6661 Get Directions Write a Review

NPPES record last updated: July 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ebisa Deressa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBISA DERESSA (NPI 1003224064) is an individual pharmacist in Portland, Oregon, licensed in Oregon (13751) and active in the NPI registry since July 2014.

NPPES Registry Identity

NPI1003224064
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameEBISA DERESSA
Location Address1123 N HAYDEN MEADOWS DRPortland, OR 97217-7547
Mailing Address1123 N Hayden Meadows DrPortland, OR 97217-7547 · (503) 205-6661 · Fax (503) 205-6661
Fax(503) 205-6661
Sole ProprietorNo
Enumeration DateJuly 22, 2014
NPI 1003224064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in OR · 13751
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
1123 N HAYDEN MEADOWS DR, Portland, OR 97217

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
1123 N HAYDEN MEADOWS DR
PORTLAND, OR 97217
Pharmacist
1123 N HAYDEN MEADOWS DR
PORTLAND, OR 97217
Pharmacist
1123 N HAYDEN MEADOWS DR
PORTLAND, OR 97217
Pharmacist
1123 N HAYDEN MEADOWS DR
PORTLAND, OR 97217

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebisa Deressa's NPI number?

The NPI number for Ebisa Deressa is 1003224064. It was assigned to this individual provider in the NPPES registry on July 22, 2014.

Where is Ebisa Deressa located?

Ebisa Deressa practices at 1123 N Hayden Meadows Dr, Portland, OR 97217. The listed phone number is (503) 205-6661.

What is Ebisa Deressa's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Ebisa Deressa was last updated on July 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.