Provider Demographics
NPI:1447725502
Name:JOURNIRX, INC
Entity type:Organization
Organization Name:JOURNIRX, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:GRAALUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, BCPS
Authorized Official - Phone:503-276-1951
Mailing Address - Street 1:100 SW MARKET
Mailing Address - Street 2:WW-AE09
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5723
Mailing Address - Country:US
Mailing Address - Phone:503-276-1951
Mailing Address - Fax:
Practice Address - Street 1:1621 SW FIRST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5713
Practice Address - Country:US
Practice Address - Phone:503-225-5367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORCON-0000016OtherOREGON BOARD OF PHARMACY