Individual
KYLE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 296-7526
Mailing address
1700 E 19TH ST, THE DALLES, OR 97058-3317
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016436
OR
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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