Individual
DEAN W MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4048 NE HIGHWAY 101, LINCOLN CITY, OR 97367-5069
(541) 994-5670
Mailing address
4048 NE HIGHWAY 101, LINCOLN CITY, OR 97367-5069
(541) 994-5670
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7878
OR
Other
Enumeration date
11/12/2008
Last updated
11/12/2008
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