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Organization
FM
Active
Organization
FM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIAN GHATAN (PHARMACIST)
(503) 839-1077
Entity
Organization
Contact information
Practice address
1839 MOLALLA AVE, OREGON CITY, OR 97045-4071
(503) 657-1483
Mailing address
16575 SW PENINSULA CT, BEAVERTON, OR 97006-7968
(503) 839-1077
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0015782
OR
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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