Individual
MR. WILLIAM FRED BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5415 SW BEAVERTON HILLSDALE HWY, PORTLAND, OR 97221-1918
(503) 246-5077
(503) 246-3107
Mailing address
15924 SW BRECCIA DR, BEAVERTON, OR 97007-8567
(503) 524-9011
(503) 246-3107
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6521
OR
Other
Enumeration date
07/07/2005
Last updated
07/08/2007
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