Provider Demographics
NPI:1447526132
Name:LIU, CHAO (RPH)
Entity type:Individual
Prefix:
First Name:CHAO
Middle Name:
Last Name:LIU
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 1:15901 SW JENKINS RD
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5045
Mailing Address - Country:US
Mailing Address - Phone:503-626-5754
Mailing Address - Fax:503-626-1187
Practice Address - Street 1:15901 SW JENKINS RD
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97006-5045
Practice Address - Country:US
Practice Address - Phone:503-626-5754
Practice Address - Fax:503-626-1187
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9290183500000X, 1835P0018X
WA20399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist