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MR. JEFFREY DVERSDAL
NPI 1104618362
Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Fairview, OR

Active since May 21, 2025
3768 NE FAIRVIEW LAKE WAY, FAIRVIEW, OR 97024(503) 459-2474 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Jeffrey Dversdal NPPES

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

MR. JEFFREY DVERSDAL (NPI 1104618362) is an individual pharmacist clinician (phc)/ clinical pharmacy specialist in Fairview, Oregon, licensed in Oregon (RPH-0010048) and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1104618362
Entity TypeIndividualMale
Primary Taxonomy1835P0018X
Provider Legal NameMR. JEFFREY DVERSDAL
Location Address3768 NE FAIRVIEW LAKE WAYFairview, OR 97024-7758
Mailing Address3768 Ne Fairview Lake WayFairview, OR 97024-7758 · (503) 459-2474
Phone(503) 459-2474
Sole ProprietorNo
Enumeration DateMay 21, 2025
NPPES CertifiedMay 21, 2025
✔ NPI 1104618362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacist · Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
Taxonomy Code1835P0018X
License✔ Licensed in OR · RPH-0010048
Definition
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
3768 NE FAIRVIEW LAKE WAY, Fairview, OR 97024
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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 Jeffrey Dversdal's NPI number?

The NPI number for Jeffrey Dversdal is 1104618362. It was assigned to this individual provider in the NPPES registry on May 21, 2025.

Where is Jeffrey Dversdal located?

Jeffrey Dversdal practices at 3768 NE Fairview Lake Way, Fairview, OR 97024. The listed phone number is (503) 459-2474.

What is Jeffrey Dversdal's specialty?

The primary specialty registered for this NPI is Pharmacist, specializing in Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, with taxonomy code 1835P0018X.

When was this NPI record last updated?

The NPPES record for Jeffrey Dversdal was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.